Since I have insisted upon the entire collection of urine voided within the twenty-four hours, my experiments have proved much more satisfactory to myself and beneficial to my patients. When searching for albumin, I have the child exercise as vigorously its is prudent before voiding urine for examination, and where the case is doubtful, I examine the urine of each micturition during the entire twenty-four hours. I need hardly say that the commonest cause of albuminuria is Bright’s disease, but I do consider it my duty to say that I believe a large proportion of the so-called “physiological or functional albuminurias” eventuate in this malady unless treated before being allowed to endure for any length of time.
We are to-day familiar with the fact that nephritis is a disease common to childhood, arising most frequently after scarletina or other blood poison. Formerly it was considered as one of the results of cold, dampness and drinking habits-its especial province the adult.
The average of disease in childhood is acute, so the prognosis for nephritis as regards complete recovery is mostly good. As a mere matter of enumeration we are perfectly familiar with the symptoms of acute Bright’s disease-the pallor, the vomiting, convulsions, urine, with a large percentage of albumin; but individual cases are of most interest just now. However B., a boy aged ten, was placed under my care. His previous history was god, except for an attack of typhoid fever some nine months previous. The boy was hardly to be called sick (from the time of his recovery from the fever until placed under my care), at least for the greater part of the time.
Ailing at times for two or three days together, causing great anxiety then, and again appearing to be, and insisting upon the fact of his being, perfectly well. There had been an occasional slight swelling of the lower limbs-a fact to which the mother attached no importance. When I first saw him he was in bed, and the swelling had been on the gradual increase. I found the lad in a condition of extensive anasarca, the action of the heart very irregular. The urine was only a few ounces in twenty-four hours; sp. gr. 1024; full of albumin and containing granular and hyaline casts.
The boy during all this time, a period of nine months of treatment, insisted that he was well. The sp.gr. of the urine rose as high as 1030, and for a period of eight months the albumin averaged throughout from a third to a sixth. From that time on it decreased from one-fifth to one-twenty-fifth, and during the last five or six days it disappeared entirely. I began treatment by restricting his diet-much to the boy’s chagrin- keeping him to milk and water, jelly, bread and butter, sweet potatoes and peptonized milk toast. Digitalis and, later on, Ferrum continually, brought the boy around. Since that time be has remained well.
A somewhat interesting case of incontinence of the urine came under my care recently-the patient a girl six years of age. The previous history, according to the mother’s statement, was one of perfect health. Application was made for admission to the public schools. The child could not gain admission until vaccinated. From that time on she was ailing, the entire body breaking out in sores. There was a discharge from the right ear, and back of the car a superficial abscess. The urine at the time was dark, contained coloring-matter and was loaded with albumin. The child was suffering at the same time from prolapsus uteri, with leucorrhoea. I need hardly speak here of the two avenues for physical examination.
There is but one way to treat such cases as the forgoing: by means of combined rectal and abdominal palpation. In the case of the child just mentioned the belly walls were both fat and relaxed, and there seemed a great possibility of considerable resistance being offered. It was important that the examination should be through, therefore I anaesthetized at once. Indeed, I think it advisable in all such cases; the effects are rapid, the duration short and the resistance slight. The rectal touch is the most certain way of approaching tubes and ovaries to be questioned, and combined with palpation by the other hand on the abdomen, is greatly enhanced in value. Rectal and bimanual massage proved very effective in restoring the pelvic organs to their normal tone.
This accomplished, the albumin, which heretofore had appeared with the greatest regularity, disappeared. No casts were discoverable; so the altered condition of the urine I considered as due to the altered conditions of pressure in the pelvic and renal circulations. The muscular tone of the patient was influenced considerably by daily applications of electricity. China proved very useful here. I had a favorable and uninterrupted action of the single prescription and minimum dose of the single indicated remedy. This Hahnemannic trio, I rejoice to say, speaks for itself without any trumpeting.
We have been accused by the Old-School men of “Never having discovered a single bacillus.” Shall we ever rally from the thrust or dare to look a brother Allopath in the face again after being told such a thing as this? And yet who is specially benefited by knowing that a certain comma bacillus is found in this or a rod-shaped one in another? We have a law, that a particular medicine produces a definite result, and that one thing we have proven to be of more practical use than the natural history of all diseases combined could ever be.
In cases of incontinence of the urine treatment must be given with an eye to the cause, the principal causes being the various motor neuroses. A large number of such cases are exceedingly troublesome; when, however, there is irritability of the bladder, I believe Belladonna will prove your friend in almost every instance. In such cases I believe we cannot lay too much stress upon message of the bladder per rectum. It has given me most excellent results, together with a daily salt-water bath, accompanied by brisk rubbing in the region of the spine; there must, too, in such cases, be a careful consideration given to hygiene and diet, and last, but by no means least, attend to the psychical surroundings.
This may, on first thought, appear overstrained and far- fetched; I make it a strong point simply because I have watched the effects on a nervous child of a nurse thoroughly uncongenial. I have seen the same kind of thing obtain in the hospital, where children were away from home, everything strange and new. It must be unnecessary for me to say that “powerful emotions” bring an increase of albumin in the urine. And, believe me, you will experience unexpected results frequently, if you turn your attention wit vigor toward this one thing.
I think, if I remember rightly, our own Dr. Clifford Mitchell lays considerable stress upon this; to my mind, it is something to be strongly considered, whatever the malady my be. I was asked, in preparing this paper, to show the prophylactic properties of Homoeopathy in relation to my subject. I confess myself almost totally at a loss here. The causes of “Albuminuria in Children” are many, are unforeseen, and it appears to me quite impossible to treat of it prophylactically. In concluding this hastily written and very imperfect paper, I should like to say a few words to our confreres from abroad.
An Englishman, some time since, said, in a way that was quite characteristic of the national generosity and kindliness of spirit, “It is the American Homoeopathists we own it-to their indomitable independence, energy and pluck-that Homoeopathy stands in the position it does to-day in the United States and before the world; aided by the free institutions of their country and the emancipated minds of the people, they have been able to achieve what we have scarcely attempted.” The gentleman who wrote those words may be here to-day; if he is, I should esteem it a pleasure and privilege to meet him.
That the onward sweep of Homoeopathy in this, our own land, has been overwhelmingly irresistible is a fact far and away beyond dispute. We owe its success, in a large measure, to the attitude taken by the Homoeopathic pioneers. If only you Englishmen would acquire or wrest the right to teach, and grant diplomas to your won students, headway would be made immediately. Why should you beg recognition from Allopathic colleges for a fact which the entire would at large accepts?
If any one thing more than another would stand as proof of the progress of scientific medicine, it is the fact that the men of the Old-School are rapidly incorporating into their materia medica our laws of cure; by giving medicines both palatable to the sense of taste and pleasant to the sense of sight, they are so thoroughly revolutionizing their style of practice that, except for the old empirical tendencies still clinging to them, we should almost fail in recognizing them. The time has arrived, I think, for sweeping some of these pirates from their medical high seats; it is being done rapidly here. In the name of these assembled Homoeopathists, let me beg of you to gird up your loins, buckle on your armor, and fight the good fight, doing for Homoeopathic in England what we have done for it in America-place it to the fore.
