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

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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$5 to 10 drops in water several times a day, and externally by inunction, are also to be recommended. lodipin is useful when the stomach and intestines are very sensitive, and is given by hypodermic injection in doses of 5 to 10 c.c. (1-2| dr.). All other remedies that have so far been recommended are distinctly less useful or of no value what- ever, [lodin as an alterative is regarded by some as of considerable value also in cases that are not syphilitic. It may be given in small doses, 3 to 5 gr. of potassium iodid, or even in the form of the syrup of hydriodic acid, the latter being especially suited to children. It has seemed to the writer, at times, that he has seen good follow the use of Donovan's solution of arsenic (liq. arseni et hydrargyri iodidi) in doses of 1 or 2 drops. And where anemia is pronounced the syrup of the iodid of iron or the pill of the iodid of iron may be of benefit.—Ed.] On the other hand, the hygienic and dietetic treatment is of the greatest importance and must be adapted to the various stages of the disease and to individual conditions. During the initial stage, before the development of marked polyuria and of cardiac and vascular com- plications, when albuminuria is slight or is only moderate or perhaps even intermittent, the same treatment may be employed as during recovery from acute nephritis (see p. 205), to which the condition is in many respects similar. It is always advisable at the beginning to insist on absolute rest in bed as an experimental measure, in order to determine whether the morbid process in the kidneys can be influenced, and if so, to what extent. If the albumin is made to disappear from the urine by that measure, as it sometimes does after several days or after one or two weeks, the patient should be kept in bed continuously for a longer period, say four or five weeks or even longer, after which he should gradually accustom himself to getting up and staying out of bed in the manner that has already been explained. At the same time, particularly in cases of intermittent albuminuria, a careful search should be made for any possible cause. In addition to the usual causes, such as fatigue, mental excitement and exposure to cold, the writer must call attention to masturbation, after the correction of which he has repeatedly seen an otherwise refractory intermittent albuminuria disappear. If rest in bed during the first one or two weeks proves ineffective or appears to have little influence on the condition itself, its further continuance usually proves futile. Under such circumstances patients should on the whole receive the same treatment as in the advanced cases. [Many patients with incipient chronic interstitial nephritis, in whom the condition has been detected perhaps accidentally, as in exam- ination for life insurance, can hardly be viewed in the light of invalids; and even though after the experimental rest albumin persists, they do not always need the treatment of an advanced case. They will, of course, exercise caution as regards excesses in diet, physical exercise, exposure to cold, etc., but by modifying their modes of living a little, by creating for themselves a slightly diiferent environment, they may have months or years of comfort and usefulness ahead of them. But it is unwise and often impossible to treat these patients as though they were seriously$