Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

286/440 (page 268)

only two are niilliparas, and of these one had carried a large ovarian tumour for eighteen years, and had acquired pendu- lous belly after I had removed it. Similar observations of cases in which the abdomen had long been distended by tumours or ascites are contributed by Oernm-TIowitz and Rollet. Ruptures are frequently found in women along with moveable kidney, as observations by liayer, &c., show. Menstruation, again, has been namedby Bequet, Lancereaux, Fourrier, and others among the influences contributing to the production of moveable kidney. According to these authors every menstruation produces congestion of the kidney and its capsule, and therefore increase of its volume, through a con- nection between the ovarian and renal plexuses, which connec- tion, however, has yet to be proved. The relaxation of the capsule,itsdistentionatnextmenstruation,'and so on, gradually enlarge it to such a degree that the kidney becomes moveable within it. Although clinical symptoms show that a connec- tion between moveable kidney and menstruation exists, and that the renal and uterine vessels are closely connected (as the investigations of Virchoiv (94) prove), a direct relation of cause and effect between menstruation and moveable kidney must be rejected, for, on the above theory no woman who menstruates should fail to have a moveable kidney. There are, however, a series of other influences, hitherto too little regarded, which demonstrate the dependence of moveable kidney on the sexual department of a woman's organism, besides such causes as repeated pregnancy, tumours of the lower abdomen, &c., which have already been men- tioned :—these arc the numerous displacements of the generative organs, the descents, prolapses, and inversions of the vagina and ibterus. In the first place these aifections have important causes in common with moveable kidney, such as impeded involution of the generative organs post partum, relaxation of the peritoneum, and rapidly repeated deliveries ; this is proved by their pathology. In the second place, however, descent of the genital organs favours the descent of the kidney by direct traction. Since the female generative organs are directly connected with the kidneys by the pexn- toneum as well as by the ureter, which runs close to the body of the uterus and in the substance of the upper third of the