THE URINE IN CONTRACTED KIDNEY.

The work of Cabot and others has shown how frequently the text-book picture of the urinary changes in kidney disease fails to correspond to the changes seen in actual practice. In chronic interstitial nephritis we have flattered ourselves that the urinary changes are apt to be characteristic, likewise the high arterial tension and the cardiac hypertrophy. Nagel¹ has recently analyzed the urinary and other changes in a number of undoubted cases of contracted kidney, and shows that some of the signs generally accepted as being almost constant are far from being so. Thus, polyuria occurs in only one-third of the cases, a normal amount of urine being secreted in a second third, and a condition midway between polyuria and oliguria existing in about one-fifth of the cases. Increased blood pressure is present in a little under three-quarters of the patients, and clinically appreciable heart hypertrophy in a little over