morning and
ending after the first specimen has been voided on the morning of the
second day.

~Preserving the Urine~ for testing is usually necessary, especially
during the warm weather. The specimens should be collected in a
wide-mouthed sterile glass jar. This should be kept in a cold place.
Some harmless preservative such as chloroform should be added to
assure its keeping.

PROBLEMS

(a) Outline tests used in urinalysis; state when they are used.

(b) List the equipment needed for making the simple tests.

(c) Make tests in laboratory and list results in note-book.

FOOTNOTES:

[110] "Treatment of Diabetes Mellitus," pp. 182-183, by Joslin.

[111] "Starvation (Allen) Treatment for Diabetes Mellitus," by Hill
and Eckman.

[112] "Treatment of Diabetes Mellitus," p. 186, by Joslin.

[113] "Chemistry for Nurses," by Reuben Ottenburg.

CHAPTER XVIII

ACUTE AND CHRONIC NEPHRITIS

Nephritis is a disease of the kidneys, in which changes occur in the
tissues of the organs themselves; these changes may be caused by
inflammation of the kidneys and renal passages brought on as results
of the retention of certain poisonous substances in the blood, or from
the action of specific bacteria. The disease may be acute or chronic
in form and develop as a result of prolonged exposure to cold and wet,
of tonsillitis, scarlet fever, typhoid fever, and to a less extent of
malaria, syphilis, pregnancy, and tuberculosis, as well as from the
effects of certain irritating drugs, such as cantharides and
turpentine.

~Directing the Treatment.~--In any case the treatment must be directed
toward the relief of the acute symptoms in the beginning and followed
up by a general treatment which will tend to strengthen and relieve
the overtaxed organs and to increase their power to functionate
normally.

~Causes and Effects.~--In acute nephritis, the chief symptoms are
uremia, and edema; the urine is materially diminished in quantity and
at times suppressed; it is often found to be rich in albumen and
containing hyaline and blood casts, red and white blood cells, and
various pigments.

In chronic nephritis, which may be the result of an acute attack, or as
a sequel of other diseases already mentioned, there is seen to be a
progressive loss of flesh and strength, marked anemia, gastro-intestinal
disturbances, increased blood tension and edema, the latter especially
in the face on arising in the morning. Uremia may deve