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Gravel or Kidney Stones.So long as these substances remain dissolved they are of course readily passed through the ureter ; but in various unhealthy con ditions of the body these crystalline substances do not remain dis solved, but are deposited as a sediment in the pelvis of the kidney. Here they form little masses called kidney-stones. Many of these masses are small enough to pass through the ureter and are washed down into the bladder with the urine, forming here a nucleus for a bladder-stone in the bladder. But many of them are too large to pass readily through the ureter, and either remain in the funnel- shaped pelvis or become lodged in the ureter. If in the latter case they are finally forced onward, their passage through the ureter into the bladder occasions the most intense pain - paroxysms which are known as " renal colic," or a " fit of the gravel. " A paroxysm of kidney colic, or a "fit of the gravel," is usually developed somewhat suddenly, though in some cases it may be preceded for hours or days by a dull pain in the back and groin. The paroxysm soon reaches the height of its intensity, the pain often being agonizing. The pain is usually felt in the region of the lowest rib on the side, radiating downward and forward into the groin, perhaps even to the thigh ; in the male it is usually felt in the testicle, which may be drawn violently up toward the body. The patient may endeavor to secure relief by changing his position, walking about the room, and by compressing the abdomen with the hands. In fact, the symptoms resemble largely those of wind colic except in the location of the pain. The suffering continues with out intermission, though not of uniform severity. There is a con stant, or frequent, desire to pass water, though but little urine is secreted, and that which is passed is often bloody Accompanying these symptoms of local difficulty are various evidences of constitutional disturbance - nausea and vomiting, profuse perspiration, pallor of the surface. After an interval which may last from fifteen minutes to one or more days, the symptoms suddenly cease, leaving the patient in an exhausted but comforta ble condition. The sudden cessation of pain is usually followed by an abundant discharge of urine ; the kidney-stone has evidently reached the bladder, and the urine which had been dammed up behind it during its passage through the ureter is now permitted to escape. It sometimes happens that other renal stones follow the first down the ureter at short intervals, so that the patient has several fits of the gravel within a few consecutive days ; in this case the succeeding ones are not usually so violent or painful as the first. Although these paroxysms are extremely painful, they are not immediately dangerous, and if the stone finally escape into the bladder the health is entirely restored ; yet one attack is apt to be followed sooner or later by others. Sometimes these fits of the gravel terminate in the discharge of a fine red sand, containing perhaps several larger masses, which collect in the bottom of the vessel containing the urine. In other cases the urine will be perfectly clear and free from gravel at the time of its passage, but will deposit a heavy sediment after stand ing a few hours. Sometimes a similar occurrence is witnessed for a few days before the attack begins. Treatment.-During the paroxysm the object of treatment is of course relief of pain. This can be accomplished by a free use of opium ; a quarter of a grain of morphine may be given to an adult and repeated in three or four hours if the pain be severe. If the stomach be very irritable, it will be better to administer the morphine by injection under the skin. In some cases, however, the pain is so severe and begins so suddenly that we cannot wait for the action of morphine; in these instances chloroform should be inhaled until the morphine, which should be given as early as pos sible, has had time to manifest its effects. Nothing can be done to promote the passage of the stone along the ureter beyond the inhalation of chloroform, which seems to relax the channel. Much can, however, be done to prevent the recurrence of these attacks. For the formation of renal stones is, in the majority of cases, due to an excessive acidity of the urine; this is especially true in those cases in which a red sand is deposited. In these cases it may be possible to ward off future attacks by preventing the urine from becoming so acid. This may be accomplished by giving twenty to thirty grains of the bicarbonate of potash in water three times a day ; or by administering five grains of the carbonate of lithia, or by giving ten grains of benzoic acid. In other cases the kidney-stones are formed of materials which are deposited from alkaline urine ; an examination of the urine and of the sediment will at once determine which variety of kidney-stones is present in any given case. The acid condition of the urine is especially apt to occur in persons of full bodily habit, who are accustomed to partake largely of meat; the alkaline condition is most frequent in nervous individuals, especially those of sedentary habits. Various mineral waters may be employed to render the urine acid or alkaline as required, though care must be taken in selecting the proper variety. If the stones formed in the kidneys do not escape through the ureter, but remain permanently in the pelvis of the kidney, they cause an irritation and inflammation which is known as pyelitis. In this affection there is apt to be a dull pain in the loins, aggra vated by violent motion. The urine usually contains a considerable sediment of pus. This disease is important, because it is so often mistaken for Bright's disease of the kidney ; in fact it is impossi ble to recognize it without the use of the microscope ; it will be, therefore, unnecessary to describe it here in detail. In all cases where there is a disposition to the formation of gravel, it is a matter of importance to regulate the diet of the patient. By this it is not meant that the patient should be starved, but that he should avoid those articles of diet which predispose to excessive acidity of the urine. It is, therefore, necessary that he abstain from excessive indulgence in meats, or at least employ at the same time a proper proportion of vegetable substances. Yet there are certain vegetables, rhubarb for example, which are especially likely to induce acidity of the urine* But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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