Acute Inflammation of the Kidneys. Nephritis.
BEFORE speaking of this disease, I wish to give the reader a general idea of a kidney, and shall do s by the use of two cuts.
Fig. 110 presents the external. surface of the right kidney, with its renal capsule mounted on top; i, being its upper edge; f, h, superior and inferior branches of the emulgent artery; c, d, c, three branches of the emulgent vein; a, the pelvis of the ureter; 6, the ureter.
Fig. 111 is the same kidney laid open; 1, being the super renal capsule; 2, the vascular portion; 3, 3, the tubercular portion, consisting of cones; 4, 4, two of the calices receiving the apex of their corresponding cones; 5, 5, 5, the three infunclibula; 6, the pelvis; and 7, the ureter.
The kidneys are glands, and their office is to draw or strain off from the body those effete or worn out particles, or products of decay which contain nitrogen, while the liver takes away those carbonaceou8 matters which have no nitrogen. These useless substances which go out through the kidneys are generally in the form of urea. In carrying off these matters, the kidneys may have more to do than properly belongs to them; and may be so stimulated, or irritated, or injured in some way, as to become inflamed.
Symptoms. Like most other inflammatory diseases, it begins with cold chills and rigors, especially in the back and loins, followed by fever and pain. The pain frequently extends to the bladder, the loins, and the thighs, and is of a severe, lancinating kind though sometimes obtuse. Pressure, motion, straining, or taking a full breath, add to its pungency. The urine is scanty, high colored, sometimes bloody, and can only be passed drop by drop. In the loins there is a sense of heat, gnawing, and constriction; the bowels are either constipated, or relaxed by diarrhea. A numbness of the thigh, and drawing up of the testicle on the affected side, are marked and peculiar symptoms. In some cases, there are nausea, vomiting, oppression of the stomach, faintness, hiccough, drumhead distention, and rumbling of the bowels. The skin is hot and dry, the pulse hard and frequent.
Causes. The use of cantharides, oil of turpentine, and other diuretics, taking cold, violent exercise, mechanical injuries, the translation of rheumatism or gout, the striking in of skin eruptions, and gravelly formations in the kidneys or ureters.
Distinctions. This disease is to be distinguished from colic by the pain being increased by pressure, and by the frequent but difficult discharge of red urine; from lumbago, from its being confined frequently to one side, and also by the urinary troubles, and by the nausea and vomiting; and from all other diseases, by the numbness of the thigh, and the drawing up of the testicles.
Terminations of the Disease. It runs a rapid course, and may terminate by resolution, or by suppuration. When the latter happens, it is indicated by the decline of the more violent symptoms, a throbbing and a sense of weight, with chills, followed by flushes of heat, and sweating. The matter formed, generally small in quantity, may pass into the. cavity of the kidney, and thence through the bladder to a natural outlet with the urine.
Treatment. Either put the feet into a hot mustard bath, or put mustard drafts upon them. At the same time apply a large mustard poultice upon the small of the back, and follow it up with hot fomentations of stramonium leaves and hops, or stramonium and wormwood or tansy.
Let perspiration be induced as soon as possible by five to ten drop doses of tincture of veratrum viride, repeated every hour, or by teaspoonful doses of the compound tincture of Virginia snakeroot, given every half hour.
If costiveness exist, the bowels must be opened by Epsom salts, cream of tartar, or salts of tartar; or by copious injections of warm water, containing a few drops of the tincture of arnica leaves. Such injections not only unload the bowels, but act as a local bath, by lying in the bowel near the inflamed kidneys.
The drinks must be mucilaginous and diuretic. The marshmallow root and peach leaves, slippery elm bark, flaxseed, mullein, elder blows, hair cap moss, and cleavers, are all valuable. If the disease is caused by gravel, twenty drops of liquor potassm, largely diluted with flaxseed and upland cranberry tea, and taken freely as a drink, is excellent. We recommend Poland water in large quantities.
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