Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel.

  • Hermann Senator
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    some degree of fatty change; while, on the other hand, in renal con- gestion the urine presents the characteristics that have already been described, and signs of congestion, such as varicose veins, are frequently found in other parts of the body. Prognosis.—Eclampsia is the only serious factor in the prognosis, and as it does not develop until shortly before or during delivery or immediately after the termination of labor, and can never be forseen, the prognosis should always be given with great caution. [While it is true that eclampsia cannot be foreseen with certainty, it must be said that one may often with reasonable certainty predict its onset by certain symptoms that may without impropriety be called premonitory. Among these are epigastric pain, nausea and vomiting, headache, unusual dizzi- ness, and flashes of light. In any pregnant woman who is beyond the fifth month, one should regard headaches of increasing frequency and severity, epigastric pain not clearly due to dietetic error, unaccountable vomiting, puffiness of the hands and face, as symptoms that portend eclampsia, and that should lead to immediate examination of the urine, which will commonly be found heavy with albumin.—Ed.] The prog- nosis cannot be said to be absolutely favorable until all danger of eclampsia has passed—i. e., in most cases three days after the termina- tion of labor, or after the eclampsia has been successfully overcome. The development of secondary chronic nephritis after kidney of preg- nancy is rare, and such an event can probably be prevented in most cases by judicious management. Treatment.—As a prophylactic measure, women who have once suffered from nephritis of pregnancy may be advised to guard against another pregnancy. [This is undoubtedly the safest advice to give. But many wives are anxious to become mothers, and when the dangers are clearly set before them, the risk is not as great as during the first pregnancy, because the kidney of pregnancy is less frequently met with in multiparse, and because the woman and physician will now be on the watch, and not only will undue effort be made to secure a hygienic mode of life, but frequent urinalyses will be made and the approach of danger generally discovered in this way. It is, of course, assumed that some time has elapsed since the first pregnancy, and that by careful exam- ination of the urine, the heart and retina, the physician is satisfied that no chronic nephritis is present.—Ed.] The treatment of the renal disease itself is concerned chiefly with hygiene and diet, as in other forms of acute nephritis, and has already been discussed in a former section (p. 202). The writer will merely insist once more on the beneficial effect of rest and the horizontal posi- tion on the hypostatic congestion in the lower half of the body and in the kidneys. As everything depends on preventing the occurrence of eclampsia, which is assumed to rest on a toxemia caused by deficient renal action, it is important, as soon as the earlier signs of failing kidney action, particularly edema, have made their appearance, to stimulate the renal, intestinal, and cutaneous excretion without, of course, doing anything
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