ALBUMINURIA.
Usually the treatment of this condition resolves itself into the manage ment of Bright's Disease. In those cases where albumin appears in the urine, apparently independent of renal disease, it may (speaking generally) be said to be in such small amount as not to call for any special treatment. Where, however, more than a trace is pretty constantly detected, the physician should determine the cause and treat it. If, as is common, the albumin appears as the result of defective assimilation of albuminoids, attention should be at once directed to the state of the digestive organs, and especially the liver; and there is no more potent remedy in such cases than a strictly milk diet, with or without Pepsin. Home-made Koumiss, prepared by mixing 1- pint of water, T pint of Irish buttermilk, pints of Fresh Milk, and r oz. Loaf Sugar, leaving in a warm place and shaking occasionally for 36 hours, will make a palatable food, very suitable in many cases. Albuminuria occurring during febrile attacks, zymotic diseases, inflammatory affections, etc., will yield to the remedies suitable for the primary disorder. When depending upon obstruction to the circulation, as in valvular affections or cirrhosis, the albumin will dis appear upon the removal of the cause when possible. Cardiac tonics and diuretics, by strengthening the heart muscle and stimulating the renal bloodvessels, may cause its disappearance. The wet pack is very serviceable in such cases.
Iron, especially in the form of acetate, is of great value in the treat ment of chronic albuminuria, especially when the drain of albumin has produced a marked effect upon the blood, and it affords the best results in albuminuria depending upon a morbid state of the blood, as in scurvy, pyemia, and hospital gangrene.
The albuminuria of adolescence, or so-called intermittent, cyclic, ortho static, or functional albuminuria, generally yields readily to rest in bed and a strict milk diet for a few weeks. In those cases where the albumin
appears after physical exercise, Yeo lays stress upon the importance of limiting this to several very short walks, and forbids all athletics and animal food. Sexual excesses, smoking, overfeeding, brain-worry, exposure to cold, and other possible causes must be guarded against.
The broad statement may be accepted as true that no drug possesses the specific power of markedly causing diminution in the quantity of albumin, and it is better for the physician to attack the cause than to lose time in administering the usual list of mineral and vegetable astringents, which are always injurious. Lactate or Chloride of Calcium sometimes, however, appears to lessen slightly the amount of albumin in cyclic and anmmic cases, and it may always have a trial, but the long list of drugs vaunted for this purpose, including strontium, gold, silver, and lead salts, may be ignored.
The albuminuria of pregnancy, when slight or transient, does not call for medication; when persisting and copious, it may be safely dealt with as if occurring in Bright's Disease (which see).
So-called War Albuminuria has recently attracted much attention, and confusion exists regarding the two distinct types of the condition. Thus a considerable percentage of the troops on active service and those under going intensive training exhibit a transient albuminuria due obviously to fatigue. This type, which in the group of men undergoing severe drilling may he as high as to per cent., is to be distinguished from the commonly recognised form of albuminuria occurring in trench warfare, which must he regarded as a true nephritis.