Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

275/440 (page 257)

and its relrition to the kidney, so that it is impossible to set at rest the doubt whether this might not have been a case of congenital displacement. (9) Moveable Kidney on the left side, with extreme viohility ; dis^lacevient of the colon (Durham, i860). At the autopsy of a woman thirty-four years of age the left kidney was seen to project remarkably. The descending colon lay much nearer the middle line than usual and instead of forming the sigmoid flexure on the left side^ it ran across the lumbar vertebrae into the pelvis to the right of the sacrum. Slight pressure caused the kidney to slip into its usual posi- tion, and closer examination proved it to be moveable not only with extreme ease but also to a great extent. When the patient moved in various suitable ways and under gentle manipulation the kidney glided away with equal case across the vertebral column and under the ribs, or even somewhat to the right side into the iliac fossa. On closing the abdominal cavity and palpating the lumbar region the kidney was felt as a smooth, oval, half-elastic tumour, which slipped away when pressed by the fingers. The peritoneum was abnormal. Instead of passing over .the anterior surface of the kidney it only just touched the lower part of its inner edge, and then after forming the des- cending mesocolon, again came into contact with the outer border of the kidney. Moreover, the lesser cavity of the peritoneum (sac of the omentum) reached so far towards t'he left side as to cover the posterior surface of the spleen, ;and so far downwards as to be in contact with the upper border of the kidney. The kidney had no distinct mesen- tery (mesonephron). In the loin hardly any fat was found but only loose cellular tissue. The absence of fat partly ex-' plains the mobility of the kidney. The renal vessels had their normal origin, but were perhaps longer than usual. The left supra-renal body moved with the kidney only to a limited extent. 17