The remedies found to be most efficient in these conditions are diuretin, copaiba, and calomel, although frequently saline purgatives, by ridding the peritoneal cavity of excess of water and preventing the accumulation of fluid by lowering the abnormally high blood-pressure in the portal circulation, prove more beneficial than diuretics.

3. To remove water from the blood when the arterial pressure is abnormally high.

For this purpose diuretics are indicated in the early stages of many acute diseases, such as the eruptive fevers, tonsillitis, bronchitis, etc. In these cases agents which dilate the cutaneous bloodvessels, such as spirit of nitrous ether, etc., should be employed. Diaphoretics and cathartics are likewise beneficial.

4. To remove injurious waste products and poisonous substances from the blood.

For this purpose drugs which stimulate the convoluted tubules and increase oxidation should be given, such as potassium nitrate and bitartrate, the lithium salts, turpentine, juniper, diuretin, and the remedies mentioned under Lithontriptics.

The foregoing remedies will be found useful in diseases associated with rheumatic, gouty, and uric-acid diathesis, as well as in many acute diseases where there is rapid accumulation of deleterious, catabolic material.

5. To lessen the acidity of the urine.

The alkalies and the alkaline salts of the organic acids are the most useful agents for this purpose, being serviceable in such conditions as gonorrhea and acute inflammatory states of the genitourinary tract. In debilitated conditions there is quite often an excessive acidity of the urine, irritating the mucous membrane and causing frequent micturition. In such cases the alkaline diuretics or alkaline mineral waters are of service.

6. To increase the acidity of the urine.

This is necessary when, from any cause, there is ammoniacal decomposition of the urine, as in cystitis. In such cases benzoic acid is probably the most beneficial remedy, though the salicylates, salol, and the volatile oils, etc., may also prove useful.

7. To prevent the formation of urinary concretions or to dissolve them when formed, as in cases of renal calculi, etc.

For these purposes the drugs included under Lithontriptics are the most efficient.

8. To dilute the urine.

This process is necessary to prevent the deposit of urinary solids from forming calculi in the kidneys or bladder. For this purpose water or the alkaline mineral waters, taken in large quantities, will prove most useful.

Administration. - Diuretics are often very uncertain in their action, in health many of them apparently exerting no influence upon the kidneys, and in diseased conditions not infrequently proving inert. They are more certain in their action when employed in combination - that is, a union of drugs which act both generally upon the systemic circulation and locally upon the various secreting structures of the kidneys. Diaphoretics, being diverse in their action, should not be given with diuretics.

When administered, diuretics should be freely diluted with water. The patient's skin should be kept cool and the bowels prevented from acting too freely, in order that the full benefit of this class of remedies may be obtained.

The diuretic drugs not described elsewhere in the present work are herewith considered in detail.