Nausea, anorexia, and dyspepsia are frequent conditions. Severe vomiting may precede an attack of nrwmia. Urmmic diarrhoea may occur, and there may also exist a catarrhal gastritis for some time, the tongue being thickly coated and the breath heavy and urin ous.
Case in which the existence of a typh litis was, for a time, suspected; true nature of the case declared by a unernic headache accompanied by blindness. Second case in which the cephalalgia was the most marked feature. These intes tinal derangements characterize so large a class of urmmics, the disturbance being generally of the nature of diarrhoea, that practitioners should constantly suspect those seeking treatment for persistent alimentary troubles of being affected with an underlying nephritis. Taylor (Cincinnati Lancet-Clinic, Nov. 15, '90).
Examination of the conditions of the stomach in twenty-six cases of chronic parenchymatous and interstitial nephri tis, mostly in middle-aged patients, show ing that renal disease has a marked in fluence upon the chemistry of gastric digestion. Kravkoff (London Med. Recorder, Jan. 20, '91).
Action of various constituents of the urine upon intestinal peristalsis. It is probable that, among the substances re tained, there is some substance directly paralyzant to intestinal movement. It is not a very uncommon occurrence to have the uramic diarrhcea followed by a condition of intestinal paralysis, and cases of urcemia have unwittingly been operated upon for the relief of a sup posed intestinal obstruction. Hirschler (Wiener med. Woch., Mar. 21, '91).
Warning against the administration of an opiate in any diarrhceal patient above 50 years of age, owing to the untoward effect of opium in cases of renal insuffi ciency. Musser (Times and Register, Oct. 17, '91).
Digestive troubles associated with dis eases of the urinary apparatus often disguise the latter. Alapy (Revue de Th6r. Medico-Chir., Oct. 15, '93).
Twenty-two cases of ulceration of the intestine coincident with renal affec tions, and eight cases of litemorrliagic extravasation without ulceration. Situ ated at all points of the intestine, but especially about the ileum, principal characteristic being that they were ac• companied by hemorrhage. Dickinson
(Brit. Med. Jour., Jan. 13, '94).
Complications in the digestive tract. Examination of 17 cases,-3 of large waxy kidneys and 10 of secondary and 4 of primary contracted kidney, — intes tinal lesions in most of them, from simple catarrh to diphtheritic exudation. Fischer (Deutsche med.-Zeit., Aug. 9, '94).
There is, as a rule, no cettema in renal sclerosis, and when it does occur (as in the ankles and limbs) it is due to car diac dilatation and failure. The skin is dry, and the pores sometimes appear lustrous with minute scales of urea.. The skin has often, also, a cyanotic tinge, with a certain degree of pallor. Trouble some eczema and pruritus are often pres ent, and muscular cramps may make the patient still more uncomfortable; the latter occur at night and especially in the calves of the legs. Other cutaneous disorders may also occur.
I. There is a bright-red diffused rash which appears chiefly on the trunk, less extensive on the neck, arms, and thighs, and very seldom on the face, hands, or feet. It is distinguished from the some what similar rash produced by natural or artificial diaphoresis by its locality. by the absence of sudamina, and by its appearing when no hot-air baths or other means have been used to produce sweat ing and when the skin is harsh and dry. As it does not, as a rule, either itch or smart, and only remains a few days. Most often seen in cases of chronic tubal nephritis.
2. There is a papular eruption with large, discrete. rather dark-red pimples seated on a dry, rough. and sometimes scaly surface. This more often seen on the outer side of the thighs and legs, the shoulders, and extensor surface of the forearms, but it also may affect the loins and the abdomen. Personally never seen on the face or on the hands and feet.
3. Apart from the mere coincidence of eczema with Bright's disease, there may be observed in some eases a moist der matitis resembling eczema in its aspect, but accompanying the arms or the legs, without affecting the flexures of the joints, the face or the ears, without the irritation commonly present, and with out having previously appeared.