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Acute Bright's DiseaseSymptoms.-The patient usually experiences a chilly sensa tion, which may be merely a slight shivering or may amount to a pronounced chill; this is followed by decided fever, nausea, vomit ing, headache and pain in the small of the back. While these symp toms are well marked in many cases, they may be less pronounced in others ; and, indeed, most of them are sometimes entirely absent. But close upon these follows a symptom which rarely fails to appear, namely, dropsy. This usually begins by puffiness under the eyes ; in a few hours the entire face as well as the feet are perceptibly swollen ; by this time there is often considerable difficulty in breath ing, the respirations being short and hurried. In children, the dis ease not infrequently causes delirium and convulsions, though these are seldom present in adults, except in rapidly fatal cases ; the skin is very dry, the face pale. But the most characteristic symptoms, those indeed upon which the physician relies for a positive opinion, are found in the urine. This is usually much diminished in quantity; in severe cases, indeed, it is almost or quite suppressed. The urine which may be passed is of a very deep color, has usually a strong odor, and deposits, upon standing, a heavy sediment. If the case be severe, this sediment contains a large proportion of blood, which may be visible to the naked eye as a brick red or brown layer, and which gives to the urine a peculiar smoky appearance. Perhaps the best estimate of the gravity and danger of the case can be obtained by the uninitiated from the quantity and appearance of the urine. In health, the average adult should pass in twenty-four hours about fifty ounces - three pints - of urine. In acute Bright's disease, the quantity may be diminished to thirty, twenty, ten or even less ounces. In the majority of cases which occur " spontaneously," that is, without any connection with the infectious diseases, recovery may be expected. After one, two or three weeks the symptoms gradually subside, the urine increases in amount and resumes a more natural appearance, the swelling of the body disappears and the patient recovers his usual health. Yet this is by no means inva riably the issue of the disease. In some cases death occurs ; in others the patient recovers a certain degree of health, but does not regain his former strength ; in still others there is an apparently perfect recovery, and the individual has no suspicion of any fur ther difficulty until, perhaps years subsequently, it is discovered that the disease has assumed the chronic form, and is firmly fixed in his system. If death occur, it is, in the majority of cases, the result of uræmia. By uræmia we mean the retention of urea in the blood. Urea is one of those substances which is produced in the various tissues of the body during the ordinary processes of life, and one of those substances which it is the especial duty of the kidney to sep arate from the blood and eliminate from the body with the urine. If the disorganization of the kidneys be extreme, that is, if the attack of Bright's disease be very severe, the kidneys fail to secrete much or any urine, and the urea, which is always produced so long as the individual lives, cannot, of course, escape from the body. Some of it, it is true, is ejected by the stomach during the acts of vomiting, which always accompany severe cases of the disease. Some of it also is expelled by the alimentary canal in a watery diarrhea, which is also apt to be one symptom of severe cases. But notwithstanding these efforts of nature to eliminate the urea, and thus to save the system from poisoning, the result is usually fatal if the action of the kidneys be nearly or quite suppressed ; for the urea is a poisonous element if it accumulate in the blood, and the patient dies from urea poisoning, or ttræmia. Another mode of death which sometimes happens is from dropsy of the chest and of the lungs. In this case the danger is indicated by the short and hurried acts of breathing, as well as by the blueness and lividity of the skin for some days before the fatal result. The occurrence of uræmia is preceded by symptoms of mental derangement, at first amounting merely to depression of spirits, then proceeding to deiirium, unconsciousness and convulsions. These are the evidences of the effects of urea on the brain. At times, too, impairments of vision and partial blindness are observed. Treatment. - As already indicated, the objects of treatment are chiefly the restoration of the functions of the kidney, and the elimination of the urea and other constituents of the blood by the skin and intestines. To accomplish the latter the skin must be stimulated to activity by heat and moisture, in the shape of warm baths, or, better by hot air baths. These may be taken once or twice a day until the patient perspires freely ; they must not be too often repeated, since they are somewhat exhausting, especially the hot water bath. The bowels may be excited to activity by cathar tics, especially by the saline purgatives. For this purpose there maybe given, morning and night, the following powder: Jalap, ------ Five grains Cream of tartar, - A teaspoonful. A pleasant and almost as efficient purgative is the citrate of magnesia. * In order to promote the excretion of the urea and other poisonous materials, the patient should be permitted the free use of water, lemonade and other bland liquids for which he may express a desire. In order to restore the function of the kidneys, but one object can be carried out-namely, to give these organs a rest. In order to accomplish this, the skin and the intestinal canal-which are really accessory kidneys, as it were-are stimulated to unusual activity by the baths and purgatives already mentioned. The same object can be promoted by the use of measures which will diminish the quantity of blood in the kidneys. The most effective means for this purpose is dry cupping over the loins. This can be imitated quite effectually in the household, either by the application of hot cloths over the loins, or by the use of a light poultice which has been sprinkled with a little mustard. These should be changed every hour or two so as to keep them hot. Dry cupping itself may be successfully done by putting into a tumbler a piece of blotting paper two or three inches long and an inch wide, saturating this with alcohol, setting fire to the alcohol, and applying the mouth of the glass quickly to the skin at the small of the back. During the burning of the alcohol the air in the glass is heated, and upon cool ing, the air contracts again and the skin is pressed slightly into the glass. In performing this little operation, care should be taken that the burning paper does not come in contact with the skin ; this can be avoided if the patient assume a sitting posture, or lie upon the side. It is quite important that the diet be judiciously selected during the disease, especially since the stomach is apt to be irri table. By employing chiefly milk and eggs we can, to a certain extent at least, diminish the work required by the kidneys. 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