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Green reports the case of a female child in which the right kidney and right Fallopian tube and ovary were absent without any rudimentary structures in their place. Guiteras and Riesman have noted the absence of the right kidney, right ureter, and right adrenal in an old woman who had died of chronic nephritis. The left kidney although cirrhotic was very much enlarged.
Of course it should be repeatedly emphasized that chronic interstitial nephritis may be in evidence with either albumin or casts alone, or without either being present. Janeway sums up his conclusions by stating that "from the time of the development of symptoms indicative of cardiovascular or renal disease, four years will witness the death of half the men and five years of half the women.
Chronic nephritis is often a coincident disease, but the causes of the arteriosclerosis and the nephritis are generally the same. Alcohol, except as a part of overeating and as a disturber of the digestion, is perhaps not a direct cause of arteriosclerosis, as alcohol is a vasodilator.
In the first stage the arteries are healthy, but the tone, owing to contraction of the muscular walls, is too great. This condition or stage has been termed "chronic arterial hypertension." This condition may be due to irritants circulating in the blood, to nervous tension, to incipient chronic interstitial nephritis, or may be the first stage of sclerosis of the arteries.
Charles W. Crumb cites the case of a man, sixty-five years old, with chronic nephritis, in whom a slight bruise of the nose was followed by epistaxis lasting twenty-four hours. When the nares were plugged blood escaped freely from the eyes.
Chronic inflammation generally develops slowly and may not give rise to any very prominent symptoms at first. The preventive treatment of nephritis consists in careful nursing of animals affected with acute infectious diseases, a clean water supply and avoiding the feeding of spoiled feeds. The curative treatment is largely careful nursing.
Patients with this trouble and with hypertension, and without nephritis, probably have an increased secretion from the suprarenals. We may sum up the prognosis in hypertension as follows: Hypertension alone is not of unfavorable omen; if it is not readily reduced by ordinary means, it is more serious. If associated with kidney, heart or liver defect, it is most serious.
But to a man with a septic wound or trench nephritis or smashed up skull, alcohol is poison and poison is death, and so it is sternly forbidden to our wounded soldiers. They cannot be served in public houses. Where, then, did the hospital defaulters get their drink? "If I was you, sir," said Marigold, "I'd keep an eye on that there Mrs. Tufton."
Any cause which tends to induce arteriosclerosis may be a cause of chronic endocarditis, such as gout, syphilis, chronic nephritis, alcoholism, excessive use of tobacco, excessive muscular labor and hard athletic work. Lead is also another, now rather infrequent, cause. Severe infections may tend to make not only an arteriosclerosis occur early in life, but also a chronic endocarditis.
She had been ill-treated by husband, child had died, another had followed soon. She developed a belief that she was Eve and had to suffer. At hospital decided that she was in purgatory and expressed a variety of other religious beliefs. She also thought she was ill-treated at hospital. Her head was asymmetrical: skull thick and eburnated. Chronic interstitial nephritis.
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