On the Causes and Symptoms of Acute Diseases (2.9)

THE kidneys, as far as regards the peculiar structure of the organ, are not productive of any great danger, even if they should suffer acutely; for, being of a glandular nature, they are mild and do not experience deadly diseases. But their office is important, namely, the secretion of the urine from the blood, and its expulsion.

It is stopped either by a stone, or an inflammation arising there, or a clot of blood, or something such; when no mischief arises from sympathy, owing to the peculiar nature of the organ affected, but the retention of the urine produces all sorts of dreadful symptoms. Heat, which is acrid, and induces nausea; a heavy pain along the spine at the loins; distention of the parts, especially of those about the hypochondrium; suppression of urine, not entirely, but they pass urine in drops, and have a desire to pass more, for there is the sensation of an overflow. But if the urine become acrid and pungent, coldness, tremblings, spasms, distention and fulness of the hypochondria

supervene. This miserable state and the conjoined feeling become similar to that of tympanites produced by indigestion, from the taking of too much food. Pulse, at first, indeed, slow and languid; but, if the evil press harder, small, frequent, tumultuous, and irregular: sleep slight, painful, not continued; and suddenly starting up as if from the stroke of a sharp instrument, they fall over again into a deep sleep as if from fatigue: they are not much deranged in intellect, but talk incoherently; the countenance livid. But if the desire of making water return again, the patients pass a small quantity in drops, along with spasms and great pains, when, for a short time, they are relieved from their sufferings, and again they experience a relapse. Of those that die, they sink most quickly who pass no urine; but the greater part recover, either from the stone dropping down into the bladder along with the urine, or from the inflammation being converted into pus, or from being gradually dispelled. For, if the urine pass easily even in small quantity, they escape death; but for a length of time they waste in constitution; the patients undergo these sufferings while still able to keep up, but gradually fall into a state of consumption. The same seasons, places, and ages induce these affections as induce those in connection with the venæ cavæ.

Sometimes blood bursts from the kidneys suddenly in large quantity, and flows continuously for many days. None, however, die from the hemorrhage itself, but from the inflammation accompanying the hemorrhage, if the bleeding is stopped; but most frequently they die of strong inflammation induced by the stoppage.