Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

273/440 (page 255)

the post-mortem the right kidney was found lying in imme- diate contact with the anterior border of the right lobe of the liver and adherent to it as well as to the gall-bladder and transverse colon by dense connective tissue, the adhesions permitting the kidney to be pushed back into its normal situation and also as far as the middle line or into the umbi- lical region (mesogastrium), though not without dragging on the liver. The outer border of the kidney looked upwards, the upper extremity inwards, the lower extremity outwards, the hilum downwards; the kidney was twelve centimetres long, seven broad, four thick ; the peritoneum investing it, as well as its capsule, thickened. The capsule was distended irregularly and in the shape of vesicles (blasig), it felt elastic and fluctuating. The substance of the gland had entirely disappeared, and in its place was found a colourless clear thin fluid, enclosed by the empty septa (Fachern), of the capsule which was shining and smooth internally. The renal vessels were elongated and contracted, the pelvis thickened and four and a half centimetres bi'oad, the ureter as far as the bladder was two centimetres in diameter, its mucous membrane reddish-grey, thickened and granular. The left kidney was firmly seated in its normal position, it was in an early stage of hydronephrosis. The size of the uterus corresponded with the third month of pregnancy. The posterior wall, which was four centimetres thick was chiefly answerable for its increased bulk. Its tissue was yellowish-red, soft, infiltrated with pus. Tho cavity was small, and occupied by glairy mucus. The pos- terior wall of the bladder was closely adherent to the uterus, and on pressing the uterus pus escaped into the bladder from several points ; the opening of the right ureter was closed, the opening of the left narrowed. In the right ovary were five serous cysts, the smallest as large as a chestnut, the largest as big as a lemon ; a cyst the size of a hazel-nut la,y at the brim of the pelvis. Urag attributes the hydronephrosis to the pressure of the uterus on the ureter.