Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

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hitherto been paid to these changes in the cadaver, the vessels being only now and then described as elongated and narrowed. The kidney which is moveable is in many cases remarkably small and light, in which case the other is hypertrophied by way of compensation. In Bayer's case the moveable kidney weighed 80 grammes, the other 150 grammes. It is usual for the kidney which is not moveable to be more deeply situ- ated than normal. In some cases the kidney substance is itself degenerated, sometimes by fatty change, sometimes by the contraction of connective tissue within it, and it is some- times in a state of hydronephrosis. Quite recently numerous cases of sarcomatous moveable kidneys have also been reported, as for instance by .Wolcott (88), Kocher (89), Jessop (go), Czerny (91), Lessen (92), and Bai'ker (93). Under such pathological circumstances as these, indeed, the mobility of the kidney is so far the lesser evil that it is not considered. Hydronephrosis of moveable kidneys has been mentioned it is true, but not brought into any closer connection with the mobility of the kidney. 8imon indeed stated expressly so late as 1876, that up to that time no case of hydronephrosis in a moveable kidney had been described. The capsula adiposa shows a pretty constant condition, being destitute of fat in many cases where there is no great degree of general emaciation. The capsule of the kidney is then like an empty bag, which is bulged forwards by the kidney as far as its size and the looseness of the cellular tissue permit: By this means a kind of mesentery of the kidney, a mesonephron, is found, which is sometimes very long {Girard, Oerum-Eowitz, Sj-c). This mesentery has been erroneously regarded by many authors [Portal, BoUet, Ehstein, 8jC.) as a congenital cause of moveable kidney. Again, the hepatic and splenic flexures of the colon are found almost constantly displaced, being either bodily depressed downwards and inwards together with their mesen- teries, or having the two layers of the mesocolon sepai-ated by the kidney which has in a sense migrated between them. A similar effect is produced by hydronephrosis, or, in the case of the broad ligament, by the growth of tumours of the