Volume 1

The principles and practice of medicine / by Rustomjee Naserwanjee Khory.

  • Khory, Rustomjee Naserwanjee.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of medicine / by Rustomjee Naserwanjee Khory. Source: Wellcome Collection.

    527/588 (page 511)
    and the condition of the kidney going from bad to worse. Increased discharge of urine, diminution of blood and albumen, abatement of fever and swelling of the body, and a more healthy appearance of the face are favorable signs. If the urine steadily decreases in quantity and contains abundant albumen, epithelium, and tube- casts, the prognosis is serious ; and if with these oedema of the lungs or glottis, or signs of uraemia set in, death is certain to follow. The prognosis as regards duration of life is somewhat more favor- able in the aged than in the young. In chronic cases the structural changes are such as cannot be repaired. As the disease progresses these changes increase more and more, and involve other portions of the kidney; the blood becomes contaminated with excrementi- tious matters, and at last a limit is reached when life cannot be sustained. The course of the disease is often very tedious. Life may be prolonged for years under care and proper attention. Un- favorable cases are those where the disease is of long duration, the skin is dry, the urine much altered in quantity and quality, and complications exist. In such cases the urine, which has previously been abundant, steadily diminishes in quantity, although the specific gravity may continue the same, and there is persistent fever. Fatal cases are those where pneumonia or pericarditis, or suppression of urine, or obstinate vomiting, or diarrhoea supervenes upon the pre- viously existing unfavorable signs. Kecovery takes place where the cause of degeneration can be removed. In cirrhosis of the kidney the prognosis is very unfavorable, but the disease may last for years, and it may be far advanced before its existence is noticed. In the waxy form the prognosis is bad, though the fatal issue may be delayed for some time. In all cases of chronic Bright's disease the prognosis greatly depends upon the circumstances and general condition of the patient. If he can be surrounded with all possible care and comforts the prospect, as a general rule, is very different from what it would be under opposite circumstances. Cornplicatiotis.—These are met with in all forms of Bright's dis- ease, but some of them are peculiar to the inflammatory forms, others to the waxy, and others to the cirrhotic forms. The complications, which are numerous, affect (1) the circulatory system; (2) the respiratory system; (3) the nervous system ; (4) the digestive system ; (5) the urinary organs ; and (6) the skin. 1. The circulatory system.—Hypertrophy of the heart is met with in advanced cases of the inflammatory form (acute Bright's disease), and in all stages of the chronic form (cirrhotic kidney). In the waxy degeneration it is somewhat rare. Endocarditis often occurs in the various forms of Bright's disease. Pericarditis is