Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

291/440 (page 273)

uretei'S by traction (sucb as may be produced by stretcbing an india-rubber tube) Ligber up than the point of application of tLe traction, as can be seen in Virchow's case.-^ Physical causes. We Lave so far studied tbe ^primary changes in tbe direct or indirect means of fixation of tLe kidney as produ- cing its mobility, but in all cases pressure from above or traction from below must contribute to its development. TLese lohysical influences are competent, by tbemselves and tvithout any previous anatomical changes of importance, to produce moveable kidney. TLus acute injury is frequently cited as a cause. In tLis case, of course, just as in cancer of tLe breast, tbe bare state- ment of the patient tLat a tumour developed in tLe abdomen after a fall or a blow, &c., sLould not be implicitly believed. In tbe case of moveable kidney as well as in cancer of tbe breast, it is an external occurrence wLicL first directs a patient's attention to the existence of the malady. The oc- currence of this lumtio traumatica renis is established by trustworthy observations. Thus observations are quoted by Bayer, Henoch, Ferher and Le Ray, in which this complaint was acutely produced by a fall from a carriage or from horseback, or by a blow on the side. If it is remembered that isolated ruptures of the liver, spleen or kidney have been found after severe injuries, tbe possibility of tbe occa- _ ' [Attention should be called in this place to a remarkable class of cases m which marked dilatation of the ureters and hydronephrosis occur. These may be described as cases of urinary obstraction from irritation. The first division of the class concerns the subjects of incontinence of urine Three c^cs are recorded by Dr. Alexander James, 'Edinburgh Medical Journal' 1878, p. 135, in which death occurred, and in the two of these in which a post-mortem examination was obtained dilatation of the ureters and double hydronephrosis was found. The second division concerns the subiects of extroversion of the bladder, in which affection a similar condition is gene- rally found (Ghampneys, ' St. Bartholomew's Hospital Eeports,' vol xvi 1880, p. Ill) m spite oE the absence of any structural obstruction to the ureters. In both of these cases the obstruction is spasmodic, and the com- parison of tl.e two classes shows that its seat must be the orifices of the ureters. The bearings of this on the previous remarks in the text are obvious.—TfiANSLATOE.] 18