(wetting the bed or getting up at night); later the excretion of urine is scant, passed frequently, or, may be, suppressed altogether. Fat; later—emaciation. Heat and dull pain in the loins[48] (small of the back), increased by pressure; slight or considerable “puffing” about the eyes, noticeable only at times, or it may be constant and unrecognized as a symptom of disease; it may be diminished at times, as the secretion of urine becomes modified, or the condition of the system happens, temporarily, to improve. And it increases often when the secretion of urine diminishes, or is passed less freely. The countenance is more or less pallid, and may have a brownish tinge. Croupy breathing accompanies œdema of the larynx. “With children, inflammation of one or other of the organs of respiration is the most fatal tendency of the disease. Not only are they liable to pleurisy, pneumonia, and bronchitis, but, also, to membranous croup.” Constant tendency to irritability of manner, easily angered, unreasonableness, petulance; with infants—constant fretting, crying, nothing will interest or amuse them.
[48] Of all portions of the body, this should be lightly covered, never sweltered with wraps, bindings, or weight of garments.
Diphtheria is, I believe, only a phase of albuminuria. Says Dr. Grasmuck, treating of diphtheria, and other physicians have observed the fact: “Another peculiarity of the scourge is its fondness for children of a certain condition—the fat, sleek, soft, tender, ‘well-fed’ children so generally admired—such children can offer but slight resistance to this disease; being, in
fact, chronically diseased, they are predisposed to ‘attacks’ of all kinds; and, living to adult age, furnish the greater proportion of cases of tuberculous disease. On the other hand,” he continues, “I do not know of a single instance where the disease proved fatal to—rarely attacking—a child of the genus ‘Street Arab’—children who spend most of their time out of doors, are thinly clad, sleep in cold rooms, have a spare diet, and who have no one to pamper them unwisely.”
Dr. Dickinson treats of albuminuria under three heads, viz., tubular nephritis, granular degeneration, and lardaceous disease. He designates, also, such other diseases as are likely to result in consequence of this disorder; and finds some of these peculiar to, or more apt to afflict, sufferers from one or the other forms. He says: “It is seen (from the table presented) that nephritis is a disease of infancy and youth, causing most deaths in the first decade coincidentally with the prevalence of scarlatina; many in the third when the toils and exposures of active life are perhaps the most prolific of evil. Granular degeneration belongs to middle and advancing life, and is most fatal between fifty and sixty. The one flourishes upon the febrile accidents [!] of childhood and the susceptibilities of youth; the other develops when the habits of life begin to tell and the effects of old age begin to appear. The lardaceous disorder has little to do with either extreme of the mortal course; it is chiefly associated with the vices of early maturity, and with tubercle and struma, disorders more incident to the young than the old, and in their suppurative form to
youth rather than childhood.” Among the diseases resulting, or likely to result, from one or other forms of the disease, Dr. Dickinson names the following: dropsy, pneumonia, pleurisy, peritonitis, bronchitis [before mentioned]; pericarditis, endocarditis, hypertrophy of the heart, with cardio-vascular thickening, [heart “diseases”]; hemorrhagic accidents [bursting of blood-vessels—apoplexy] depending as they do upon structural changes of the vessels; diarrhœa.
SOME OTHER SYMPTOMS.
Nasal catarrh; the radical suppression of this discharge is likely to be followed by serious if not fatal kidney disease.[49] (To remove the former by removing its cause, thus rendering the discharge unnecessary, is quite another thing). Hence the danger of using so-called catarrh remedies, or of adopting any specific local treatment: they are either inert or injurious.
[49] As illustrating this point I will mention the case of M. K., of Troy, N. Y.,—a case of successful (?) self-treatment for catarrh. This patient had for a dozen or more years suffered with nasal catarrh, and had tried most of the advertised “specifics” without avail; in fact, the disorder steadily increased. At last, the twice daily snuffing of slightly soapy water, for some weeks, “cured” him, as he said; but simultaneously with the suppression of the catarrhal discharge there resulted (without, however, any thought of connecting the two events, in the mind of the patient) an excessive flow of urine, extreme thirst, etc., etc.; in short, true diabetes. In this case great relief was experienced from an exclusive diet of skim-milk for five months, the patient swallowing nothing else for that length of time, except two tablespoonfuls, daily, of wheat-bran thoroughly chewed, “for the bowels.” At the end of the five months the patient weighed 210 lbs. This he realized as excessive, and my attention being directed to the case at this point, the patient at my suggestion adopted the bread and fruit diet—discontinuing the skim-milk and bran—and gradually reducing his weight by moderate diet and increased exercise, went on to a complete recovery.