The influence of arsenic upon this condition is well worthy of further investigation. A case of "acute renal anasarca" in a woman, aged nineteen, is briefly recorded from Dr. F. Farre's practice

(Lancet, i., 1862); six weeks after the commencement of the attack she developed psoriasis, for which Fowler's solution was prescribed, and under its influence the albumen disappeared, and the patient gained flesh and strength. I have for many years used it in albuminuria following scarlatina; it removes the dry inactive condition of the skin, checks thirst, and causes a copious flow of urine, which gradually becomes less loaded with albumen; should dyspnoea be present, the remedy quickly relieves it, and the oedema of face and body disappears. In 1876 a case came under my care of chronic character, occurring in a builder, aged forty-three, of dissipated though hard-working habits; he had general anasarca and epileptiform convulsions, which were relieved for a time by laxatives, but the amount of albumen was uninfluenced by them, or by a long-continued use of iron. Fowler's solution was substituted, and the albumen diminished and soon ceased to appear; then, omitting the medicine, a relapse occurred; this again yielded on resuming the remedy, and the albumen, anasarca, and convulsions all disappeared, and in two to three months the patient's health was quite re-established, and he has since been quite well. I have also treated by liquor arsenicalis, with excellent results, numerous cases of temporary or intermittent albuminous urine dependent on imperfect digestion.

Dr. Brunton has discussed this subject in an interesting and scientific paper (Practitioner, June, 1877): he remarks on the important distinction between "true and false" albuminuria (Gubler), including under the latter term, not only the presence of albumen from pus or blood, but also the so-called Bence Jones' albumen, egg-albumen, the albumen absorbed from the intestine after imperfect digestion: it is a case of the latter kind that is recorded by him as being much benefited by arsenic, and it had several peculiarities. The patient was aged thirty-three, sallow and thin; the first symptom was great fatigue on exertion, then albuminuria was noticed (on examination for life insurance): it was at first present only during the summer; it came on after work and ceased on rest; it ceased also under strychnine (but this caused headache and sickness), and it ceased during quiet residence at the seaside. Fatty food brought it on, and meat taken in the morning, not when taken at night. Quinine and phosphoric acid at once increased the quantity, but rigid adherence to a farinaceous diet quite controlled it, and there were other evidences of its direct connection with digestion. After many years of treatment, including milk-diet, sea-voyages, digitalis, hydrarg. c. creta, etc., Dr. Brunton ordered 3 min. of Fowler's solution at meal-times, "and almost at once the albumen disappeared, and the patient was able to do much more work than usual, without its return." Later, the medicine was changed for hypophosphite of soda, and the albumen returned, to cease again on resuming arsenic. The whole case is very interesting, but we need only mention further that pancreatine, which increases pancreatic digestion and aids in the solution of albumen, was also found beneficial. This affection should be classed under faulty digestion or assimilation rather than as renal disorder. The special form of chronic albuminuria in which I have proved its value is that dependent upon venous congestion, mitral disease, or emphysema, after the right ventricle has begun to yield, but it deserves a trial also in cases where the actual kidney structure and epithelial lining are affected. I have carefully watched many of these latter cases in which the beneficial action of arsenic was very marked.