BLOOD IN THE URINE. (Haematuria). Causes.—The congestion of the kidneys, pernicious malaria, etc., nephritis, tuberculosis, kidney stones. The urine looks smoky and dark, or bright red.
Treatment.—This depends upon the cause. The patient must rest in bed and the kidneys should not be stimulated. Cold applications to the loins. Hot applications would injure.
URAEMIC TOXAEMIA.—This means poison in the blood occurring in acute and chronic nephritis (inflammation of the kidneys). The cause is unknown. The disease is acute and chronic.
ACUTE URAEMIA. Symptoms.—The onset may be sudden or gradual. The headache is severe, usually on the back top of head (occipital) and extending to the neck; there is persistent vomiting with nausea and diarrhea attending it. This may be due to inflammation of the colon. Difficulty in breathing, which may be constant or comes in spells. This is worse at night, when it may resemble asthma; fever if persistent, is usually slight until just before death. General convulsions may occur. There may be some twitching of the muscles of the face and of other muscles. The convulsions may occur frequently. The patient becomes abnormally sleepy, before the attack, and remains so. One-sided paralysis may occur. Sudden temporary blindness occurs sometimes. There may be noisy delirium or suicidal mania. Coma (deep sleep) may develop either with or without convulsions or delirium, and is usually soon followed by them; sometimes by chronic uraemia or recovery.
CHRONIC URAEMIA.—This develops most often in cases of Arterio-sclerosis or chronic interstitial nephritis, (one kind of Bright's disease). The symptoms are less severe than those of acute uraemia, but similar, and of gradual onset, sometimes with symptoms of the acute attack. There is often constant headache and difficult breathing; the tongue is brown and dry, sometimes there is nausea, vomiting, diarrhea, sleeplessness, cramps of the legs and much itching may be present. It may last for years. Death may occur when the patient is in coma (deep sleep). There may have been mania, muscular twitchings or convulsions before death.
Treatment.—Found under "Chronic Interstitial Nephritis."
[KIDNEY AND BLADDER 157]
ACUTE BRIGHT'S DISEASE. (Acute Inflammation of the Kidneys. Acute Nephritis).—This occurs chiefly in young people and among grown men. Exciting causes are exposure to cold, wet, burns, extensive skin tears (lesions), scarlet fever, diphtheria, typhoid fever, measles and acute tuberculosis, poisons; and pregnancy is one cause when it occurs in women.
Symptoms.—After exposure or scarlet fever the onset may be sudden, sometimes with chills or chilliness, variable fever, pain in the loins, watery swelling of the face and extremities, then of other portions of the body like the abdomen, then general dropsy. Sometimes there is nausea, vomiting, headache, delirium, or very deep sleep. The urine is scanty, dark colored, of increased "specific gravity" and contains albumin, cells and casts. Anemia is marked. After some fever disease, the onset is gradual with anemia, swelling of the eyelids, face and extremities; scanty thickish urine containing casts, then headache, nausea, vomiting, little or no fever, dry skin. In these cases there may be gradual recovery, attack of uraemia, or they may end in chronic nephritis.
Diagnosis.—Examine the urine often in pregnancy, scarlet fever, etc., and especially when watery swelling is noticed.