Statistical figures, compiled by Fuerbringer, on the. duration and mire of the disease in isolated cases are of great interest. Thus, Lang stein had 17 cures in 47 cases within a year; Schur 12 cadets in a short time; Heubner, who furnishes the valuable information that he has convinced himself of the complete health of his patients for a period of nine years, had nine positive and five probable cures. Of Mery's 16' cases 11 recovered; of Schaps' 11 cases 4 recovered. 'Von Stejskal reports 2 positive cures of 10 orthotie patients and le Noir 1 cure in spite of 3 pregnancies. Kannegiesser re-examined 29 orthotics and found nothing pointing to nephritis in 14 of them. Lommel, Matthes and others take the affection to last from 2 to years, and this seems to be the rule, although by no means free from exceptions. Neukirch, for instance, re ported a cure after the affection had lasted for five years. Finally, cases of 15, 17 and even 20 years' duration have been communieated, sonic; of the patients being more than 30 and 40 years old (Martins, Heubner, Posner, Lenhartz). Thus, orthoties may well obtain a life insurance policy, which no doubt they often do, although the majority contract the disease between the ages of 7 and 15.
Nevertheless, it cannot be denied that there is a certain degree of inferiority in individuals affected with orthotic alburninuria, as evi denced by clinical experienee ancl further illustrated by the fact that these individuals are frequently a prey to tuberculosis. The latter fart, indeed, has led to the suspicion of the existence of close relations between tuberculosis and albuminuria. Furthermore, von Leube cites Wash burn's experience, according to which 39 persons with "physiologic albuminuria," whose lives had been insured, showed a mortality of 17.9 as against the expected figure of 9 per mille.
Treatment. strict differentiation between orthotic alburninuria and nephritis must needs find adequate expression in the treatment.
There would be no sense in ordering children with orthotic albuminuria to abstain from physical exercise. The object of a rest cure in the decub itus is simply to arrest 'the albuminous excretion for the time being, as it immediately reappears upon the child's rising. It may, however, impair the general condition, appetite and disposition, which may aggravate the complaint. An exclusive milk diet, which is still often prescribed in nephritis, would be complete failure, since it impairs the general condition of the child, increases the pallor of the complexion, without doing any good whatever. Children with orthotic albuminuria should have the same nourishment as healthy children of the same age and go through the same amount of physical exercise. Fresh air living in forest or mountain regions is advisable. So is stimulation of the skin and circulation by massage and friction. Edel advises gymnastic exercises, and they may be tried. It is clear, however, that children should not undergo any excess of physical or mental labor and that they should be protected from catching cold by clothing them in accordance with the weather conditions. In anorexia tonic stimulants are indicated, and iron preparations often do good. In young women with "albu mintnia of puberty" the administration of 2 to 3 Bland's pills 3 times daily has shown excellent results. Should there be simultaneous lordosis I do not—contrary- to Jelile—advise the application of a corsage. Even if albuminuria should cease with the correction of t.he lordosis, it would not. improve the genera] constitution, and that is the object to be worked for. All treatment should be avoided that might impress the child with the fixed idea of being ill, for by doing so, neuropathy might be artificially cultivated, which would be a greater evil than a harmless albuminuria.