DURATION.--(1) The Primary Cases.--The class of cases characterized by cerebral symptoms are of short duration. The bad cases die at the end of a few days, the milder cases recover within a few weeks. The class of cases characterized by dropsy last longer, often for several months. (2) The Secondary Cases.--The renal symptoms continue during the course of the primary disease, and may disappear with the termination of this disease. But if the nephritis is severe the renal symptoms may continue for months after the primary disease has run its course. Albumen and casts are especially apt to persist for a long time. Such a persistence of the nephritis is especially apt to occur with scarlatina and diphtheria. {80} PROGNOSIS.--(1) The Primary Cases.--The cases characterized by both dropsy and cerebral symptoms usually end fatally. The cases characterized by cerebral symptoms alone are also very apt to die. The cases characterized by dropsy and anæmia often get well, but the albumen and casts may persist for a long time, and the patient may have several attacks of such a nephritis. (2) The Secondary Cases.--Here the prognosis varies with the intensity of the nephritis. The more severe forms of the inflammation may add very much to the danger of the primary disease or may persist for a long time afterward. TREATMENT.--(1) The Primary Cases.--In the cases characterized by dropsy the first indication is to get rid of the dropsy, and this is to be done by the methodical use of diuretics, cathartics, and diaphoretics. It will be found, however, that there is a great difference in the different cases as regards the precise time when these remedies will take effect and the dropsy decrease. Usually it is the best plan during the first few weeks of the disease to keep the patient confined to bed or to the house, and on a milk diet. From time to time efforts should be made to reduce the dropsy, but if these efforts produce no effect they should be discontinued and then tried again. In addition to the dropsy the condition of the stomach and the anæmia require treatment. For the stomach the milk diet is perhaps the most efficacious treatment. For the anæmia iron given by the mouth, combined with daily inhalations of oxygen gas, is of very great service. It is very important in these cases to guard against relapses. If possible, the patients should not return to their ordinary pursuits for a year after their apparent recovery, but should spend that time in travelling and improving their health in every possible way. In the cases characterized by cerebral symptoms it must be confessed that treatment is not very efficacious. Diuretics have no effect, cathartics seem to do no good. Systematic sweating, the use of pilocarpine in small doses twice a day, inhalations of nitrite of amyl, the administration of chloral hydrate, caffeine, digitalis, and convallaria, and the use of fluid food in small doses, are indicated.