Treatment of urremia consists in lavage of the stomach, the intestine, and the blood. The object is to diminish the sources of intoxication. Possibly the patient has hyperchlorhydria; then the stomach sometimes contains very power ful toxins. In such a case, with contrac tion of the extremities, a toxin has been isolated capable of killing a rabbit in a few minutes.
In lavage of the intestine, ordinary enemata are not sufficient. Twice or thrice a day one should introduce, by a long, soft tube, 3 pints of boiled water containing 7 per cent. of table-salt.
In la vage of the blood, it is not neces sary to introduce saline solution directly into the veins. The introdnctiou subcu taneously of 7 to I0 or even 17 ounces, twice or thrice a day, acts almost as well. Three and a half pints have been injected at a time. In a month, one patient re ceived 29 pints subcutaneously and 21 by the rectum.
The "three lavages" have given excel lent results in the treatment of uraemia. This treatment is preferred to emetics and purgatives. Purgatives, emetics, and bleedings should not be altogether re nounced, however. Sometimes blood letting, in considerable quantity, should precede the subcutaneous injection. H. Huchard (Jour. des Pract., Feb. 4, '9fl).
In cases of uraemia, both acute and chronic, in which an exclusively milk diet is badly borne, pure water, to gether with an exclusively vegetable diet, is of value. Under this treat ment it has been found hi these cases that every trace of albumin disappeared from the urine, and generally the propor tion of albumin under such dieting was less than under a milk diet pure and simple. The treatment should be tempo rary, only lasting a few days. Renon (Revue Thar., July 1, '99).
As it seemed certain that the blood of the renal veins would contain the essen tial principles of the internal secretion of the kidney, it was suggested that injec tion of such blood might yield still better results. A special experimental study of the question was made in the Lyons Hos pital. The blood of the renal veins of a
young and healthy goat was drawn asep tically, its serum was allowed to sepa rate, and then it was put up in 20-cubic centimetre bottles. This serum gave rise to no unpleasant effects when injected subcutaneously, and was used in three cases of uraemia with good results. In generally showed itself within three hours of an injection. The violent headache first disappeared, while the nervous troubles, prostration, etc., were sometimes replaced by almost exuberant gaiety. Vomiting ceased after a single injection, and the oppression and dysp ceased after a short time, the urine becoming abundant as the oedema disap peared. Ugner°lles (Treatment, Oct. 12, '99).
After using ether in the treatment of uriemia daring several years, conclusion that it is especially valuable in cases of urremie dyspnwa, the ether acting as a stimulant to the nervous system and as a diuretic. It is administered every hour, or even every half-hour, if need be, in doses, sub cutaneously, with 1 drachm by the mouth alternately. The procedure is painful and is best restricted to patients in coma. It must be introduced deeply under the skin and cellular tissue to avoid sloughing. If injections cannot be used, a drachm or more may be given with syrup and water every half-hour. Rapid improvement follows. The num ber of injections or internal administra tions should be reduced as soon as the dyspncea subsides, and discontinued en tirely only when diuresis is thoroughly established. The method is only effect ive, of course, in kidneys that are partly fulfilling their functions, and good effects are observed chiefly in cases of chronic interstitial nephritis. Lemoine (Zeits. f. Rationelle Prakt. Aerzte, Apr., 1900).
The use of saline solution subcutane ously, intravenously, or per rectum sometimes saves cases in which all other measures have failed.