Arterio-Sclerotic Form

Category: Kidney and Bladder

This is the most common form in this country, and
is secondary to arterio-sclerosis. The kidneys are not much, if at all,
contracted; very hard, red and show patches of surface atrophy. It is seen
in men over forty who have worked hard, eaten freely, and taken alcohol to
excess. They are conspicuous victims of the "strenuous life," the
incessant tension of which is felt first in the arteries. After forty, in
men of this class, nothing is more salutary than to experience the shock
brought on by the knowledge of albumin and cast tubes in the urine.

Symptoms. Perhaps a majority of the cases are latent (hidden) and are not
recognized until the occurrence of one of the serious and fatal
complications. There may have been no symptoms to suggest to the patient
the existence of a dangerous malady. In other cases the general health is
disturbed. The patient is tired, sleepless; he must get up two or three
times at night to pass urine; the digestion is disordered, the tongue is
coated; the patient complains of a headache, failing sight, and gets out
of breath by exercising. There may be vomiting, headache, neuralgia, and
increase of the quantity of urine is common. This is light in color, of
low specific gravity, 1005 to 1012; frequently there is a trace of albumin
and a few casts of the hyaline and granular kind. In the late stages the
albumin may be increased with high specific gravity and a less quantity of
urine. The disease often lasts for a year.

In the arterio-sclerotic variety the urine may be normal or diminished in
quantity, specific gravity normal or increased, the casts are more
numerous, and the albumin is usually more abundant. There is an
enlargement of the heart; the pulse is increased in tension; the wall of
the artery is thickened. The skin is usually dry, with eczema common, but
dropsy is rare, except when it is due to heart failure. There may be
bronchial and lung troubles; attacks of uraemia, or hard breathing caused
by the heart, frequently occurs. There may be hemorrhage of the brain or
hemorrhage of the membranes, and these are often fatal.

Recovery. Chances are unfavorable, but life may be prolonged for years,
especially with care and especially if it is discovered early.

Treatment. A quiet life without mental worry, with gentle but not
excessive exercise, and residence in a climate that is not changeable
should be recommended. A business man must give up his worry; his rush;
his hurried eating, and rest. The bowels should be kept regular; there
should be a tepid water bath daily, and the kidneys should be kept acting
freely by drinking daily a definite amount of either distilled water or
some pleasant mineral water. Alcohol, tobacco, excessive eating and
improper food must not be allowed. Weak tea and coffee may be allowed. The
diet should be light and nourishing. Meat should not be taken more than
once a day. If it is possible, the patient should be urged to move to a
warm equable climate during the winter months, from November to April,
like that of southern California. Medicines must be given to meet the
indications. No special directions can be given. The heart, stomach, and
bowels must be watched.

DIET as Allowed by a Prominent Hospital.

May Take:--

Soups. Broths with rice or barley, vegetable or fish soup.

Fish. Boiled or broiled fresh fish, raw oysters, raw clams.

Meats. Chicken, game, fat bacon, fat ham (sparingly).

Farinaceous. Hominy, oatmeal, wheaten grits, rice, stale bread, whole
wheat bread, toast, milk toast, biscuits, maccaroni.

Vegetables. Cabbage, spinach, celery, water-cresses, lettuce, mushrooms,
mashed potatoes, cauliflower, onions.

Desserts. Rice and milk puddings, stewed fruits, raw ripe fruits.

Must Not Take:--

Fried fish, pork, corned beef, veal, heavy bread, hashes, stews,
battercakes, lamb, beef, mutton, gravies, peas, beans, pastry, ice cream,
cakes, coffee, tobacco, malt or spirituous liquors.

Next: PYELITIS
Previous: CHRONIC INTERSTITIAL NEPHRITIS. (Sclerosis or Cirrhosis of the Kidneys)

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Arterio-Sclerotic Form