Albuminuria, Or Blight's Disease, a disease characterized by the presence of albumen in the urine, a more or less general dropsy both of the cellular tissue and the internal cavities, and an organic change in the substance of the kidneys; so called from the name of its discoverer, Dr. Bright. The acute form of the disease sometimes commences with a chill, followed by more or less fever, with a dry skin, furred tongue, and frequent pulse. In other cases the attention of the patient is attracted by the swollen state of his countenance; the swelling rapidly extends and becomes general; at the same time the urine is greatly diminished in quantity, and is of a dark color, looking as if impregnated with smoke, or red, and evidently containing blood. There is more or less dull pain about the loins, with a dry pallid skin, thirst, disinclination for food, often nausea and vomiting. Sometimes, though happily not often, there is complete suppression of urine. In such cases, as a rule, fatal coma quickly supervenes. In the course of the disease, effusions into the cavities of the pericardium,' the pleura, or the peritoneum, with or without inflammation of those membranes, are apt to occur; or epileptic convulsions may come on, often ending in fatal coma.

The urine has commonly a specific gravity of from 1.015 to 1.025 - not varying much from its ordinary standard; when tested by heat and nitric acid, it shows the presence of albumen, sometimes in such large quantity that the whole of the fluid is converted into a jelly-like mass. When examined under the microscope, the sediment deposited by the urine, on standing, is found to consist of blood corpuscles, of renal epithelium, and of small fibrinous casts of the uriniferous tubes, containing entangled in them epithelial cells and blood globules. After the disease has continued some weeks in adults, the epithelial casts, as they are termed, sometimes contain a few oil globules; if the patient recover, these gradually disappear as convalescence comes on. On post-mortem examination the kidneys are found to be enlarged, and gorged with blood. Sometimes their exterior is pale, and this paleness extends through the cortical substance, particularly in the cases which follow scarlet fever. Microscopic examination shows many of the convoluted tubes to be crowded with epithelium, especially in those parts of the cortical substance which appear pale to the naked eye. - Of the causes of acute albuminuria, exposure to cold, particularly when the body is exhausted by fatigue, by recent illness, by an innutritious or unsuitable diet, or by excessive indulgence in alcoholic liquors, is undoubtedly the most important.

The actions of the skin and of the kidneys are always to some extent vicarious of each other. When there is free perspiration, the quantity of urine is diminished; in cold weather it is increased. In these cases, however, it is only the watery parts of the excretion which are interfered with; and the kidneys continue to free the blood from the excrementitious matters which it is their peculiar function to separate. When disease follows exposure to cold, it is probable that the sudden checking of the function of the skin produces a vascular congestion of the kidneys, an increased pressure of the blood in their vessels, and thus the appearance of albumen in the urine. Other diseases in which the blood is in an altered condition are occasionally attended or followed by albuminuria; thus repeated instances of its occurrence have been met with in connection with acute rheumatism,, typhus fever, erysipelas, and purpura. During the desquamative process in scarlet fever, the patient is liable to acute albuminuria. Accurate observers have found that in most cases albumen can, at some time of the later period of the disease, be discovered in the urine. If at this time the patient be incautiously and unduly exposed to the influence of cold, disease of the kidneys attended by dropsy is apt to follow.

The attack differs in no respect except its cause from the acute albuminuria which occurs under other circumstances; it has similar symptoms, and post-mortem examination reveals similar appearances. The strumous diathesis predisposes to the disease; cases of scarlet fever in children of that diathesis have always to be watched most carefully, and from the ordinary causes of albuminuria the strumous suffer in large proportion. - It is easy to understand the pathology of the disease. Not only is the urine diminished in quantity, but what is passed is deficient in urea. The urea which should be eliminated by the urine accumulates in the blood and poisons that fluid. The serum of the blood, of which the albumen is drained off by the kidneys, becomes deficient in that substance, and of lower specific gravity. The pallor of the complexion shows that the blood is deficient in coloring matter; and where the disease has lasted a short time, this is confirmed by direct examination, the blood globules being diminished in proportion. The circulation of a poisoned blood throughout the body causes that liability to secondary diseases which so strikingly characterizes the complaint.

While acute albuminuria is always a serious disease, still in a large proportion of cases we can look forward hopefully to the recovery of the patient; yet it must always be borne in mind that at any time secondary disease may be lighted up, which will seriously complicate the case and increase the danger. The existence of the strumous diathesis in a marked degree, or of debility from previous illness, is likewise an exceedingly unfavorable circumstance. The more recent the disease, the better is the prospect of recovery; while the persistent presence of albumen in the urine after a certain time leads us to fear the occurrence of chronic degeneration. The albuminuria following scarlatina generally terminates favorably, and there is no tendency to a return of the disease. When convalescence commences, the urine becomes more copious and pale, and for some time is discharged in large quantity, while the albumen gradually diminishes; but the patient cannot be considered as safe, so long as any trace of albumen can be detected in the urine, or any epithelial casts are discovered under the microscope. - The hygienic treatment of acute albuminuria is sufficiently simple.