Acute Bright’s disease. (Acute Inflammation of the Kidneys.  Acute Nephritis).—­This occurs chiefly in young people and among grown men.  Exciting causes are exposure to cold, wet, burns, extensive skin tears (lesions), scarlet fever, diphtheria, typhoid fever, measles and acute tuberculosis, poisons; and pregnancy is one cause when it occurs in women.

Symptoms.—­After exposure or scarlet fever the onset may be sudden, sometimes with chills or chilliness, variable fever, pain in the loins, watery swelling of the face and extremities, then of other portions of the body like the abdomen, then general dropsy.  Sometimes there is nausea, vomiting, headache, delirium, or very deep sleep.  The urine is scanty, dark colored, of increased “specific gravity” and contains albumin, cells and casts.  Anemia is marked.  After some fever disease, the onset is gradual with anemia, swelling of the eyelids, face and extremities; scanty thickish urine containing casts, then headache, nausea, vomiting, little or no fever, dry skin.  In these cases there may be gradual recovery, attack of uraemia, or they may end in chronic nephritis.

Diagnosis.—­Examine the urine often in pregnancy, scarlet fever, etc., and especially when watery swelling is noticed.

Recovery.—­The result in your children when it comes with scarlet fever is not so good.  It may run into chronic nephritis.  In adults when it is due to exposure the rule is recovery.

Treatment.—­The patient must be kept in bed until there is complete recovery.  He should be clothed in flannel.

Diet and Nursing.—­This must be of milk, water or mineral water in large quantities; milk or buttermilk should be the main article of food.  You can give gruels made of arrowroot or oatmeal, barley water, beef tea and chicken broth.  But it is better to stick strictly to milk.  As the patient gets better, bread and butter, lettuce, watercress, grapes, oranges, and other fruits may be given.  The return to a meat diet should be gradual.  The patient should drink freely of mineral waters, ordinary water or lemonade, these keep the kidneys flushed and wash out the “debris” from the tubes.  One dram of cream of tartar in a pint of boiling water, add the juice of half a lemon and a little sugar; this when taken cold is a pleasant satisfactory diluting drink.  Cream of tartar one dram, juice of lemon, sugar sufficient, water one pint, may be given whenever desired.  There should be hot water baths daily or oftener; or you can produce sweating by placing hot water jars around the patient, and watch to see whether it is too weakening.  It can also be done by introducing steam underneath the bedding, that is then lifted a little, so that the steam vapor can circulate about the patient.  Be careful not to burn the patient with the hot steam.  This, of course, is done through a hose attached to a steaming kettle.  Also see treatment of dropsy under “scarlet fever.”