. A practical treatise on medical diagnosis for students and physicians . ave en-largement due to obstruction ofthe channels causing hydro-nephrosis. The symptoms due to al-teration of function are: 2. Cardiovascularsymptoms, including dropsy andanozmia. 3. Alterations of theurine. 4. Disturbances of mic-turition. The symptoms ofrenal disease are therefore bothsubjective and objective. Diagnosis of Renal Diseases. The recognition of renaldiseases is based upon evidenceof the history, the subjectivediagnosis, the objective diag-nosis, the physical examina-tion, and the laboratory dia
. A practical treatise on medical diagnosis for students and physicians . ave en-largement due to obstruction ofthe channels causing hydro-nephrosis. The symptoms due to al-teration of function are: 2. Cardiovascularsymptoms, including dropsy andanozmia. 3. Alterations of theurine. 4. Disturbances of mic-turition. The symptoms ofrenal disease are therefore bothsubjective and objective. Diagnosis of Renal Diseases. The recognition of renaldiseases is based upon evidenceof the history, the subjectivediagnosis, the objective diag-nosis, the physical examina-tion, and the laboratory diag-nosis. Historical Diagnosis. Age,sex, and habits are importantfactors. Acute nephritis attendsany age, but chronic nephritisoccurs late in life and with theonset of cardiovascular degen-erations. The habits and hy-gienic conditions causal in thelatter are likewise induced inthe former. A previous his-tory of infections, notablyscarlet fever, is usual in acuteand chronic renal processes. Chronic intoxications, as with metals, are also followed by renal 11J 6 DISEASES OF THE KIDNEYS. Subjective Diagnosis. The chief symptoms which demand inquiryare pain and disturbed micturition. Pain. (See Chapter VIII., Part I.) Disturbances of Micturition. There are four causes of frequent micturi-tion : (1) disease of the kidneys, the ureters, or the bladder ; (2) an increasein the amount of urine, as in diabetes; (3) concentration of the urine, asin fevers, gout, or acute nephritis ; (4) reflex irritation or pure neurosis. Increased frequency of micturition occurs in almost all organic affec-tions of the genito-urinary system. It is seen in all forms of congestionand inflammation of the kidneys. In some forms of nephritis theincreased frequency may be due to increase in the amount of urine aswell as to increased sensitiveness of the organs. In chronic nephritis itmay not be noticed save that the patient is called upon to pass urine atnight, being aroused from sleep for the
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