Arterio-Sclerotic Form

Categories: 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.