KIDNEYS, DISEASES OF.—The kidneys being organs of very complex structure, it is natural that they may become diseased in various ways. Only the more important affections of these organs are here discussed.
Bright's Disease.—Inflammation of the urinary tubes, causing degenera tion of the kidneys. This affection has been so named after an English physician, Richard Bright, who first described it (1827). The disease ma\ be either acute or chronic. The acute form occurs as a complication in many infectious diseases, such as diphtheria, measles, smallpox, typhoid fever, pneumonia, malaria, and pymnic and septic fevers (especially scarla tina) ; and also after severe exposure and colds. It may be brought about also by dwelling in cold and damp rooms and by poisoning with acids, highly irritating ethereal oils, cantharides, etc. The onset of the affection is usually characterised by changes in the urine and in the general health. The disease appears either suddenly, with fever, violent chills, vomiting, difficulty in passing the urine, and pains in the regions of the kidneys ; or it sets in very gradually, with weakness, severe headache, nausea, marked pallor, and with symptoms of dropsy in the face, the hands and the feet. The urine, which is passed in small quantities, contains much albumin, and is pale red to brownish-red in colour ; on standing it deposits a sediment which contains a great deal of blood.
The chronic form of the disease may be the result of an acute attack of the affection ; but it generally develops slowly and insidiously. All the causes mentioned under the acute form may be factors also in bringing about the chronic type. It is most frequently incurred by repeated exposure to cold or drenching, by dwelling in cold and damp rooms, by the constant ingestion of food which irritates the kidneys (spices, for instance), by the abuse of alcohol, and by long-lasting suppuration, pulmonary tuber culosis and syphilis. The course of the disease is often concealed under the symptoms of catarrh of the stomach, pallor and anwinia, severe headache, shortness of breath, and general weakness ; or it may manifest itself by the development of DROPSY and UR.EMIA (which see), and by palpitation, enlargement, and weakness of the heart. Only expert chemical and microscopical examination of the urine will lead to correct diagnosis of the affection. Chronic Bright's disease may terminate in recovery in a year or two ; hut some patients may have the disease for twenty years, or even longer. The prospects of cure are favourable with appropriate treatment,
but are greatly impaired by neglect and by the supervention of serious complications.
In order to prevent attacks of Bright's disease, careful regulation of the general mode of living is of great importance. Bodily over-exertion, constant dwelling in cold and damp houses, and repeated exposure to rain and cold, may be harmful in this as well as in other respects. Occupations which expose the body to cold and wetting should be avoided. After a drenching it is important to remove the wet clothing as soon as possible, to rub the body with warm and dry towels, and to put on dry garments. The general mode of living, and the use of stimulating foods greatly influence the activity of the kidneys. From early youth the body should be hardened by cold ablutions and regular exercise ; and scrupulous cleanliness should be observed. These precautionary measures afe of great value in enhancing the resistance of the body, because of their stimulating action upon the vital functions. Excessive eating, the inordinate and continued use of meat diets and of strong spices, and the excessive drinking of alcoholic beverages, coffee and tea, cause marked irritation of the kidneys, and may give rise to chronic inflammation. Even a single excess may be followed by injurious consequences.
Owing to the intimate relations existing between the urinary and the genital apparatus, affections of the latter demand the immediate and most careful medical treatment in order that harmful reactions upon bladder and kidneys may be avoided. Care should be taken never to retain the urine for any great length of time. One should always yield to the call of nature at once, without being influenced by social regards and misguided modesty. Forcible retention of urine may be followed by very disagreeable consequences. In cases where catheterisation is necessary, as in narrowing of the urethra, enlargement of the prostate gland, and inflammations of the bladder, it is of great importance to observe the utmost caution and the most scrupulous cleanliness, especially if the patient himself attends to the catheterisation. See CATHETERISM. In order to prevent changes in the position of the kidneys from taking place, women should avoid too early rising after childbed, especially when the abdominal wall is abnormally relaxed, as after repeated childbirths. Tight waistbands and corsets should likewise be avoided at such times.