Volume 1
A text-book of medicine for students and practitioners / by Adolf v. Strümpell.
- Adolph Strümpell
- Date:
- 1911
Licence: Public Domain Mark
Credit: A text-book of medicine for students and practitioners / by Adolf v. Strümpell. Source: Wellcome Collection.
796/874 page 762
![of iron, U. S. P.] may also be sometimes used to advantage in uraemia. We are not apt to interfere with uraemic vomiting or uraemic diarrhea, because these symptoms, as we have said, are to be regarded as a form of self-help by the organism. Only when such symptoms are very distressing do we give cracked ice, morphin, opium, cocain, chloroform, etc. If the vomitus contains ammonia, it is a good plan to give 10 or 15 drops of dilute hydrochloric acid in water several times a day. An abundance of liquids is always to be pre¬ scribed upon the appearance of uraemic symptoms, because in this way it is probable that the poisonous blood is diluted and also the excretion of the toxins promoted. We would also briefly mention here that in severe nephritis with lasting anuria and threatening or already developed uraemia (especially in the eclampsia of pregnancy), the bold attempt has repeatedly been made to free the swollen kidney tissue from its internal pressure, and thus to restore the suppressed urinary secretion by operative splitting of the kidney capsule and decapsulation of the kidney. This therapeutic measure has as yet received little support, although a number of surprisingly good results have been ob- . tained. At any rate the ingenious suggestion of Edebohls deserves further consideration. In severe cases the patient’s dyspnoea often demands prompt relief. If the dyspnoea be caused, or at least increased, by hydrothorax, and we do not suc¬ ceed in removing the hydrothorax in any other way, it is necessary to evacuate it by puncture. In acute nephritis, indeed, we may hope by this means some¬ times to preserve the patient’s life until improvement sets in. Great ascites must also be relieved by tapping. Against “ renal pneumonia ” our remedies are powerless. Tepid baths, shower baths, and wet packs sometimes procure relief. In “uraemic asthma ” morphin injections may act beneficially. If pul¬ monary oedema ensues, the heart again is chiefly to be considered. We may try, besides the remedies already mentioned, large mustard plasters, baths, and acetate of lead. We accordingly see that many remedies are at our service in the treatment of nephritis, the choice of which in the individual case must be committed to the personal judgment of the physician. In the main, we should always begin with the necessary hygienic measures, and, if possible, with a methodical diaphoretic treatment, and govern ourselves otherwise by symptomatic indica¬ tions. After recovery has set in, great caution is still necessary for a long time. The patient must guard against physical overexertion, errors in diet, and exposure to cold. Preparations of iron are to be prescribed when there is a secondary anaemia. In regard to the influence of the onset of an acute nephritis on the treat¬ ment of the primary disease, we may mention that cold baths are in general not to be freely used, as in typhoid fever with nephritis, but still they may be tried if they are otherwise urgently desirable. We would also suggest that certain internal remedies, especially calomel and salicylic acid, must be used only with great caution when there is nephritis.](https://iiif.wellcomecollection.org/image/b3136276x_0001_0796.jp2/full/800%2C/0/default.jpg)
