occurring in acute and
chronic nephritis (inflammation of the kidneys). The cause is unknown. The
disease is acute and chronic.

ACUTE URAEMIA. Symptoms.--The onset may be sudden or gradual. The headache
is severe, usually on the back top of head (occipital) and extending to
the neck; there is persistent vomiting with nausea and diarrhea attending
it. This may be due to inflammation of the colon. Difficulty in breathing,
which may be constant or comes in spells. This is worse at night, when it
may resemble asthma; fever if persistent, is usually slight until just
before death. General convulsions may occur. There may be some twitching
of the muscles of the face and of other muscles. The convulsions may occur
frequently. The patient becomes abnormally sleepy, before the attack, and
remains so. One-sided paralysis may occur. Sudden temporary blindness
occurs sometimes. There may be noisy delirium or suicidal mania. Coma
(deep sleep) may develop either with or without convulsions or delirium,
and is usually soon followed by them; sometimes by chronic uraemia or
recovery.

CHRONIC URAEMIA.--This develops most often in cases of Arterio-sclerosis
or chronic interstitial nephritis, (one kind of Bright's disease). The
symptoms are less severe than those of acute uraemia, but similar, and of
gradual onset, sometimes with symptoms of the acute attack. There is often
constant headache and difficult breathing; the tongue is brown and dry,
sometimes there is nausea, vomiting, diarrhea, sleeplessness, cramps of
the legs and much itching may be present. It may last for years. Death may
occur when the patient is in coma (deep sleep). There may have been mania,
muscular twitchings or convulsions before death.

Treatment.--Found under "Chronic Interstitial Nephritis."

[KIDNEY AND BLADDER 157]

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,
vomitin