Echafolta in Renal Hemorrhage.

M. F. Hall, M. D., Clearwater, Nebraska

On November 5, 1908, Mr. S., aged 64 years, developed a case of hematuria. The quantity of urine was normal, acid in reaction, specific gravity 1024; it contained albumen, of course, as there was so much blood; it was indeed a decided hemorrhage, yet it does not require a very great amount of blood to give the normal urine passage quite a bloody appearance. At times it was a bright red as if fresh from the arterial capillaries; at others it was dark from standing in the bladder and ureters. The patient was up and around the house six or seven hours every day. The temperature was normal or one-half degree subnormal, pulse rate 68; at times up to 96. A close physical examination failed to find any lesions in the bladder, prostate or ureters, he did not complain of any pain except a dull ache in the kidneys, especially the left, and upon palpation the kidneys were found to be quite sensitive, especially the left being considerably so. The temporal veins stood out in bold relief, the head throbbing with every heart beat.

Concluding from these symptoms that I was dealing with a case of passive congestion of the kidney or kidneys and that the hemorrhage was a capillary oozing from the engorgement, I studied over the treatment. Ergot, being a remedy preeminently for congestion, was employed in substantial doses for seven days with no relief whatever. Belladonna, belonging to this class, was also tried several days, with no permanent benefit. Gelsemium was used for throbbing in the head and veratrum to soften the bounding pulse, which was satisfactorily accomplished. About this time I wrote to Dr. Ellingwood for some suggestions, and being also desirous of further information, I sent a sample of urine to Dr. Crummer of Omaha for microscopical examination, which he said revealed considerable pus as well as blood; but no form of kidney elements could be recognized, to show that it might be of malignant origin.

Feeling now that I needed a harmless antiseptic for internal use and something which possessed astringent qualities as well, echafolta was immediately employed, as this remedy does have this effect in external contused or lacerated wounds and capillary stasis. I gave 18-drop doses every three hours during the first twelve hours. The improvement was phenomenal, within the next twelve hours the hemorrhage had entirely ceased, the patient being very grateful, after five weeks' duration of the difficulty.

One pleasant thing about this is that I tried several good remedies, alone and in combination, and that the echafolta alone accomplished desired results in twenty four hours, not by its antiseptic qualities alone but by its effect on the congested capillaries as well. This remedy may be far more important in such cases than we think, and I will be glad to hear reports from readers of the THERAPEUTIST of any similar cases

Ellingwood's Therapeutist, Vol. 3, 1909, was edited by Finley Ellingwood M.D.