Parasites (Distoma hcematobium, Filaria sanguinis—echinococcus); also more rarely acute nephritis, especially scarlatinous. In Bright's disease hcema turia is observed also when malignant neoplasms are present. Renal Inema turia may be caused by scurvy, hmmo philia, etc.; it occasionally accompanies infectious diseases, such as variola, mor billi, scarlatina, typhoid fever, cholera, exanthematous typhus, recurrent fevers, yellow fever, erysipelas, etc.; it is rarely seen in syphilis, but in intermittent fever it is a frequent symptom (see MALARIAL FEVERS).
Case of lnematuria seen in a young girl. The girl had been exposed to ty phoid infection; she presently was taken severely ill, and for thirty-five days hcematuria ran along with a high tem perature, and upon the fall of fever dis appeared entirely and completely. Oliver (Brit. Med. Jour., May 26, 'SS).
In some cases the hmaturia is idio pathic, and is not to be explained by any of the above-mentioned etiological fac tors.
Hrematuria observed consecutive to mountain-sickness. Luzzatto (Gaz. degli Ospedali, May 1, '98).
Two cases of hmaturia of pregnancy; one developed in the seventh month, the blood coining from the right kidney; in the second case the hmaturia oc curred in the sixth month. In all there are about 12 reported cases. The bleed ing may be either vesical or renal, but is practically always associated with a dis tinct lesion. Guyon and Albarran (La Presse Med., No. S4, '99).
Prognosis.—The prognosis of limma turia depends on the quantity of blood lost and the gravity of the disease which causes the bleeding.
Treatment.—In all forms of lileina tnria rest and cold are the most impor tant therapeutics; in bleeding from the urethra and the bladder cold may be applied by injections of ice-water or ex ternally; in bleeding from the urethra compression may be useful; also astrin gent injections have been employed (nitrate of silver, acetate of lead, tannic acid, perchloride of iron, etc.); when the bleeding is accompanied by painful mic turition, narcotics are recommended.
In cases of vesical hammturia, injec tions into the bladder, after it has been thoroughly cleared of blood, of V,„ solu tion of tannin, recommended. Donna dieu (Med. Chronicle, July, '93).
Bleeding from the ureters, pelvis, or kidneys is treated by rest, cold, and ternal medication of secale, ergotine, tannic acid, arbutin, acetate of lead, per chloride of iron, fluid extracts of melis Virginica or of hydrastus Cana densis. In chronic cases of heematuria
the balsams may be tried.
Case of recurrent nephritis with severe hcematuria treated by the subcutaneous injection of gelatin. Six drachms of a 2 per-cent. solution of pure gelatin in physi ological saline solution injected beneath each clavicle. This was repeated next day, and followed by the oral administra tion of half a litre of 10-per-cent. gelatin solution daily for a week. All previously tried hremostatics had failed. Gelatin was speedily and permanently successful. The pain was not great and the alarming after-effects reported by Boinet, Barth, and others did not occur. Schwabe (Then. Monats., June, 1900).
Case of obstinate and dangerous hnmaturia associated with pain in the right lumbar region. After prolonged and fruitless treatment by other means, 200 cubic centimetres of sterile 23-per cent. solution of gelatin were injected subcutaneously, occasioning much pain, but promptly stopping bleeding. Coss ner (3liinchener med. Woch., 43, No. 2, 1901).
An ounce of normal saline solution to which 2 per cent. of pure gelatin is added and given subcutaneously, to gether with the internal administration of 1 drachm (4 grammes) of a 10-per cent. gelatin solution has been very ef fective in relieving a personal case of luematuria in a young woman 25 years of age. Where a nephritis exists the in ternal administration of the 10-per-cent. solution should be avoided. as hxmo globinuria is increased and renal casts appear in large numbers, and danger of urtemia is induced by such large doses.
But, when given subcutaneously with an interval of twelve or twenty-four hours, the hcemorrhage from the kidneys or nose stops immediately.
Some patients suffer considerable pain from these injections, while others do not. No abscesses have resulted, be eau;e the solutions were rendered asep and the injections were given under careful antiseptic precautions. Duffield (harper Bull.. Dec.. 1901.) When the bleeding is caused by calculi or by tumors these are to be removed by operation, if possible; when the blood comes from the kidneys and only one kidney is diseased, it may be necessary to remove the diseased kidney; in some in stances only an exploratory incision has been made, the kidney has been replaced after a careful examination by which no reason for the bleeding was the operation has resulted in complete recovery. (For the treatment of malarial htcmaturia see MALARIAL FEVERS.)