Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

267/440 (page 249)

(i) Moveable Kidnetj uii the right side, violent- gastric loaiii. Death in consequence of apo^jlexy. (Aberle, 1820). A man, tliirty-two years of age, who liad suffered for many years from severe abdominal and digestive disturbances, had been much distressed for the last thi'ee years by a tumour in the abdomen, situated in the right hypochondriac and umbilical regions, which drove him to the use of various, and sometimes injurious remedies. This supposed tumour could be squeezed upwards at the patient^s pleasure, when he lay in a particular position in bed, especially in the morning. Under these circumstances, a firm, smooth, not tender body, of the shape and size of a hen's egg, could be felt more or less to the right, somewhat above and near to the navel, which however, when not fixed from above by the pressure of the hand, slipped away again from the examining finger, often quite suddenly, and retired to the right side, backwards and upwards beneath the liver. By degrees the tumour grew and could be pushed in front of the bodies of the lum- bar vertebrge. As the diagnosis remained doubtful, the physicians refrained from active measures; the patient how- ever fell a victim to a consumptive disease and died with symptoms of apoplexy. At the autopsy, with, the exception of the softening of the right corpus striatum, &c., the several organs were found healthy; the tumour however was formed by the right kidney which was found very moveable in its normal position in the right loin, fi'om whence it could be very easily dis- placed in front of the bodies of the lumbar vertebree beneath the duodenum downwards and forwards, that is to say, in the very same direction in which the supposed tumour appeared and disappeared again during life. Its vessels were com- paratively long j the cellular capsule of this kidney (fascia renalis) was completely destitute of fat, the hepatic flexure of the colon was unusually distant from the liver, and de- pressed somewhat towards the middle of the abdominal cavity. The kidney seemed to Aberle congenitally predisposed to mobility, and this tendency appeared to him to have been encouraged by the repeated attempts to render the tumour