Bowels, Attention to.—­They should be moved every morning by a saline (salt) cathartic, if necessary, especially if the dropsy continues.  This produces watery stool.  Cream of tartar and epsom salts, equal parts, is good remedy; one-half teaspoonful every three hours for a child one year old until the bowels move freely; one-half to one ounce can be given to an adult.

[158 Mothers’ remedies]

Chronic Bright’s disease. (Chronic Parenchymatous Nephritis.  Chronic Diffuse Desquamative or Tubal Nephritis.  Chronic Diffuse Nephritis with Exudation).  Causes.—­Young adult life and most common in males.  It may come from acute inflammation of the kidneys that was due to exposure, pregnancy, or scarlet fever, or follow excessive use of alcohol, etc.  In children it usually follows acute inflammation of the kidneys or scarlet fever.

Condition.—­The kidneys may be enlarged, with thin capsule, white surface, cortex thickened and yellowish, or whitish (large white kidney).  The epithelium of the tubules is granular, or fatty or the tubules are distended and contain casts.  Cells of the “Glomeruli” and their capsules are swollen.  There is moderate increase of interstitial tissue.  In other cases, the “small white kidney,” the kidney is small and pale either at first or as a later stage of the large white kidney.  The surface is pale, rough and granular; the capsule is thickened and partially adherent; the surface is thin with white and yellowish areas of fatty degenerations.  The interstitial tissue is much increased; epithelial degeneration in the tubules extensive.  There is also the large red kidney, and with any of these types the left heart may be enlarged and the arteries thickened.

Symptoms.—­If it occurs after acute nephritis the symptoms of acute nephritis subside, but anemia and the changes in the urine persist.  Usually there is a gradual onset with paleness and puffiness of the eyelids, ankles or hands in the morning.  Later there is difficult breathing, increased watery swelling of the face, extremities and dependent portions of the body; worse in the morning.  There is a pasty yellowish pallor, afterwards dropsy of the abdominal and chest cavities.  The urine is diminished, high colored, specific gravity usually 1020 to 1025 with much albumin.  Many casts which are named hyaline, granular, epithelial and fatty.  The action of the heart is bad.  There may be trouble with the stomach and bowels, constipated, etc.  The digestion is poor and the patient frequently suffers with much gas.  Recovery is rare after it has lasted one year.