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 b