Nephritis / by Carl von Noorden.

Date:
1903
Catalogue details

Licence: In copyright

Credit: Nephritis / by Carl von Noorden. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    this plan of treatment in kidney troubles just as they have given it up in heart disease, thanks to Oertel. In contracted kidney it is true we must exercise still more care than in heart diseases; for in renal cases we must consider the heart as much as in heart cases proper, and in addition the blood vessels and the kid- neys. Tire exact amount of muscular exercise that is to be permitted in each case must be determined by a study of the individual peculiarities of each patient. The reaction of the heart and, of course, the constitu- tion of the urine are the chief determining factors. Physical exercise influences the degree of albuminuria in contracted kidney as well as in acute and subchronic nephritis, also in juvenile cyclic albuminuria, although not to such a marked extent as in the first named dis- orders. Rest in bed frequently leads to a considerable decrease in the excretion of albumin, but that does not justify us in keeping patients of this kind in bed; if we were to adopt this plan we would have to keep them in bed for months and years without really ben- efiting them to any great extent. In patients who are up we also frequently find considerable differences in the amount of exercise they take. The increase of albu- minuria is however only transitory if the patients are gradually accustomed to greater physical efforts (by gymnastic exercises, mountain climbing, etc.) ; in the great majority of cases we will find that the degree of albuminuria drops back to the original level as soon as the heart and the muscles grow stronger. In many cases we may even fail to notice this transitory in-