Acute nephritis is an acute inflammation of the kidneys, characterized by albumen, and other pathological elements, in the urine. The disease may develop into chronic nephritis. Chronic nephritis, or Bright's disease, may also originate without having been preceded by any acute symptoms.

Causes

Most of the acute cases are caused by the poisonous matter resulting from such infectious diseases as scarlet fever, diphtheria, typhoid fever, small-pox and malaria. Other infectious diseases or diseases resulting from self-poisoning are also causes. Any condition which hinders the functional activity of the skin, or that throws additional work on the kidneys, may cause acute nephritis. This may also be the case in diseases of the skin, extensive burns, or from cold and exposure which arrest its functional activity. The kidneys perform a very important function in removing poisons or poisonous substances from the body, and are, therefore, likely to be greatly affected by them. This is especially true of lead and alcohol in all its forms. Painters and others who work in lead are much subject to this complaint. A distinguished medical writer classes Bright's disease as of uric acid origin, which is but another name for poison resulting from effete matter in the system. In addition to these general causes, Bright's disease undoubtedly has a nervous origin, which comes from shock, emotional excitment and high nervous tension.

Hereditary tendencies are very pronounced in some families, as evidenced by the fact that entire families have died of the disease.

Symptoms

The symptoms are mainly constitutional. In acute nephritis there may be dropsical effusions. These are often manifested by swelling of the face, feet, legs and other parts of the body, with diminished amount of urine. In the acute attacks, there may be chilliness, pain in the back and limbs, dull headache and general physical weakness. In chronic nephritis, or Bright's disease, there may be attacks of nervousness, indigestion, headache, and particularly shortness of breath after climbing a stairway. There is no pain to warn the patient, and it not unfre-quently happens that people have Bright's disease and are hopelessly incurable before they ascertain the fact. A chemical analysis of the urine is easily made, and no physician should be permitted to practice medicine who does not make frequent examinations of this kind. In disease, the exact condition of the kidneys is best determined by a microscopical examination.

Diet

There is no food that gives as good results in diseases of the kidneys as milk. In some cases, it will be best to use it almost exclusively for some months. If it does not agree with the patient, or is not sufficiently nourishing to sustain the strength, well-baked bread, or rice that has been boiled several hours, or until the grains disintegrate, may be used to thicken the milk. Should there be constipation, rolled oats may be substituted for the bread and rice. If the patient loses strength he may be given wheat gluten and powdered nuts and fish. The latter is the only meat ordinarily allowable, but some permit a small amount of chicken. Where the digestive organs are in good condition and the patient has considerable vigor, a moderate amount of green vegetables may be allowed, but never in acute attacks. Neutral fruits, or those somewhat sweet, will not likely do any harm. They should always be baked or stewed. In Bright's disease all irritating substances, such as pepper, mustard and condiments generally, are prohibited. Likewise all meat, except fish, and chicken occasionally; all pungent vegetables, such as raw onions, together with alcoholic liquors of every description, vinegar, sour fruits, tea and coffee.

It is of greatest importance that the skin be kept in the most active condition possible. Daily baths, followed by thorough rubbing of the skin for a half hour, is essential to good condition and a prolonged existence. Chronic Bright's disease is classed among the incurable ones, but those who are so afflicted must not worry about it, as it doubles their speed towards the end. With good care, one may live many years with Bright's disease, and be much alive long after some of those who were supposed to be more fortunate, have passed away.