Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

169/440 (page 151)

wear woollen under-clotliing. Our object is best attained by keeping the patients in bed for as long a period as is possible, for weeks, and if necessary for montlis ; tbe adoption of tbis plan keeps the skin under tbe most favourable conditions for promoting its function. It involves also another point, which is an important one as regards treatment, viz. it prevents as far as 2Jossible muscular movement. Observations have repeatedly proved, as I stated in my essay of last year, that active muscular exertion increases the albu- minuria. The obvious cause of this increase I then explained, and I need not now recur to it. The patients must, therefore, be prevented from taking excessive exercise, and even when we wish to give them the benefit of fresh air, which is highly desirable owing to the anaemia characteristic of renal affec- tions, all active exercise must as far as possible be avoided, and the patients must not walk or run or ascend heights, &c., but confine themselves to driving about, under proper precautions against chills. But otherwise it will be best to confine the patients to their beds, where so many favorable conditions exist in combination. In addition to the three above-mentioned points with regard to the diet, the cutaneous function and muscular repose, there are a few other conditions which influence the course of albuminuria, and which are, therefore, deserving of consid- eration ; among these axe psycliical influences. It is probable that some of you have noticed that sudden affections of the mind, such as anger, fear, &c., increase the albumen in the urine. Several very striking instances of this kind have come under my own observation. The rule must, therefore, be adopted of guarding the patients as much as possible from such influences, and the best way to do this is to enforce a prolonged withdrawal from business and other avocations. In the last place I have observed that the albumen is regularly increased in female patients during menstruation. I need scarcely say that this observation refers to perfectly pure urine, and not to such as contains any admixture of menstrual blood. It may be that the pelvic congestion which occurs in menstruation, causes an increase in any inflamma- tory processes , which exist in the kidneys, and thus augments the albumen ; or perhaps the various systemic processes.