Treatment.  Diet.—­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 keep strictly to milk.  As the patient gets better, bread and butter, lettuce, watercress, grapes, oranges and other fruits may be given.  The return to the meat diet should be gradual.  The patient should drink freely of mineral water, ordinary water, or lemonade.  These keep the kidneys flushed and wash out the “debris” from the tubes.  One dram (teaspoonful) of cream of tartar in a pint of boiling water, add the juice of a half a lemon and a little sugar.  This when taken cold is a pleasant, satisfactory drink.  Medical treatment is not satisfactory.  The only thing to do is to give medicines to meet the indications; fifteen to twenty grain doses of lactate of strontium.  Diuretin also is used.  Basham’s mixture for anemia is of help in some cases.  It can be bought at any drug store.

[Kidney and bladder 159]

Chronic interstitial nephritis. (Sclerosis or Cirrhosis of the Kidneys.  Granular, Contracted or Gouty Kidney).—­This is met with, (a) as a sequence of the large white kidneys forming the so-called pale granular or secondary contracted kidney; (b) as an independent primary affection; as a sequence of arterio-sclerosis.

Causes.—­The primary form is chronic from the onset, and is a slow creeping degeneration of the kidney substance, and in many respects an anticipation of the gradual changes which take place in the organ in extreme old age.  Families in which the arteries tend to degenerate early are more prone to this disease.  Doctor Osler says:  “Among the better classes in this country Bright’s disease is very common and is caused more frequently by over-eating than by excesses in alcohol.”

Arterio-Sclerotic Form.—­This is the most common form in this country, and is secondary to arterio-sclerosis.  The kidneys are not much, if at all, contracted; very hard, red and show patches of surface atrophy.  It is seen in men over forty who have worked hard, eaten freely, and taken alcohol to excess.  They are conspicuous victims of the “strenuous life,” the incessant tension of which is felt first in the arteries.  After forty, in men of this class, nothing is more salutary than to experience the shock brought on by the knowledge of albumin and cast tubes in the urine.

Symptoms.—­Perhaps a majority of the cases are latent (hidden) and are not recognized until the occurrence of one of the serious and fatal complications.  There may have been no symptoms to suggest to the patient the existence of a dangerous malady.  In other cases the general health is disturbed.  The patient is tired, sleepless; he must get up two or three times at night to pass urine; the digestion is disordered, the tongue is coated; the patient complains of a headache, failing sight, and gets out of breath by exercising.  There may be vomiting, headache, neuralgia, and increase of the quantity of urine is common.  This is light in color, of low specific gravity, 1005 to 1012; frequently there is a trace of albumin and a few casts of the hyaline and granular kind.  In the late stages the albumin may be increased with high specific gravity and a less quantity of urine.  The disease often lasts for a year.