e are so prolific as
intemperance. A scrofulous diathesis, or habit of body, may strongly
predispose to the disease, and chronic kidney disease frequently follows
acute rheumatism and the practice of masturbation. In some instances the
chronic form of Bright's disease follows an acute attack, but is more
often developed slowly and insidiously without any known cause.

THE SYMPTOMS of this fatal malady generally appear so gradually that
they excite but little or no concern until it has reached its more
advanced and dangerous stages. Frequently, a puffy, watery or flabby
condition of the face, particularly under the eyes, is the first symptom
noticed, and the patient may observe that his urine is diminished in
quantity. The urine is sometimes abundant, but generally more scanty
than in health, is acid in its reaction, and generally of a low specific
gravity. The countenance is generally somewhat pale and bloodless,
which, taken with the dropsical condition of the system, and the
constant albuminous condition of the urine, points the expert specialist
to Bright's disease of the kidneys. Various circumstances and conditions
may give rise to the temporary presence of albumen in the urine, and,
although albumen may be temporarily absent from the urine even when
Bright's disease exists, yet this is not common. There are certain
indirect symptoms which point clearly and almost unmistakably to the
presence of this disease. These are deep-seated pain or weakness in the
back, gradual loss of flesh, red, brown, or dingy urine, more or less
drowsiness, and as the disease advances, a smothering sensation, or
difficulty in breathing, with dropsical puffiness or swelling.
Occasional attacks of nausea and vomiting are common; pains in the limbs
and loins, which are often mistaken for rheumatism. Irregularity of the
bowels is also common. The skin becomes harsh and dry, not perspiring
even under active exercise. Sometimes these symptoms are years in their
development, being very obscure at first, and in some cases the disease
has been known to prove fatal without the patient having experienced any
extraordinary symptoms. With those whose systems are enfeebled by want,
intemperance, exposures or disease, as scrofula or syphilis, the first
symptoms usually observed will be a frequent desire to urinate,
occasional attacks of diarrhea, flatulency, dropsical swelling of the
face, especially under the eyes, and afterwards of the extremities,
p