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CHRONIC BRIGHT'S DISEASE. (Chronic Parenchymatous Nephritis). Causes





Category: Kidney and Bladder

Young adult life and most common in males. It may
come from acute inflammation of the kidneys that was due to exposure,
pregnancy, or scarlet fever, or follow excessive use of alcohol, etc. In
children it usually follows acute inflammation of the kidneys or scarlet
fever.

Condition. The kidneys may be enlarged, with thin capsule, white surface,
cortex thickened and yellowish, or whitish (large white kidney). The
epithelium of the tubules is granular, or fatty or the tubules are
distended and contain casts. Cells of the "Glomeruli" and their capsules
are swollen. There is moderate increase of interstitial tissue. In other
cases, the "small white kidney," the kidney is small and pale either at
first or as a later stage of the large white kidney. The surface is pale,
rough and granular; the capsule is thickened and partially adherent; the
surface is thin with white and yellowish areas of fatty degenerations. The
interstitial tissue is much increased; epithelial degeneration in the
tubules extensive. There is also the large red kidney, and with any of
these types the left heart may be enlarged and the arteries thickened.

Symptoms. If it occurs after acute nephritis the symptoms of acute
nephritis subside, but anemia and the changes in the urine persist.
Usually there is a gradual onset with paleness and puffiness of the
eyelids, ankles or hands in the morning. Later there is difficult
breathing, increased watery swelling of the face, extremities and
dependent portions of the body; worse in the morning. There is a pasty
yellowish pallor, afterwards dropsy of the abdominal and chest cavities.
The urine is diminished, high colored, specific gravity usually 1020 to
1025 with much albumin. Many casts which are named hyaline, granular,
epithelial and fatty. The action of the heart is bad. There may be trouble
with the stomach and bowels, constipated, etc. The digestion is poor and
the patient frequently suffers with much gas. Recovery is rare after it
has lasted one year.

Treatment. Diet. Milk or buttermilk should be the main article of food.
You can give gruels made of arrowroot or oatmeal, barley water, beef tea,
and chicken broth, but it is better to keep strictly to milk. As the
patient gets better, bread and butter, lettuce, watercress, grapes,
oranges and other fruits may be given. The return to the meat diet should
be gradual. The patient should drink freely of mineral water, ordinary
water, or lemonade. These keep the kidneys flushed and wash out the
"debris" from the tubes. One dram (teaspoonful) of cream of tartar in a
pint of boiling water, add the juice of a half a lemon and a little sugar.
This when taken cold is a pleasant, satisfactory drink. Medical treatment
is not satisfactory. The only thing to do is to give medicines to meet the
indications; fifteen to twenty grain doses of lactate of strontium.
Diuretin also is used. Basham's mixture for anemia is of help in some
cases. It can be bought at any drug store.





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

Previous: ACUTE BRIGHT'S DISEASE. (Acute Inflammation of the Kidneys)



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