Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

302/440 (page 284)

to be regarded as hysterical, inasmuch as we find them of the same kind and intensity in women who are not hysterical, and in men. One sign that these painful sensations are not hysterical is that they are increased by sudden movements or great bodily exertions, but in the recumboiit position and during rest they disappear. Besides these vague, insufficiently localised sensations of pain, one not uncommonly observes circumscribed neuralgias in remote spots, arising reflexly through dragging on the nervous plexuses and ganglia which plentifully surround the kidney. Now the capsule of the kidney normally lies upon the two last branches of the lumbar plexus, and is surrounded by a rich network of sympathetic ganglia. Thus we often find pains down the front of the leg as far as the knee, between the ribs, in the loin, and in the abdomen. Sometimes these radiate as they do in liver affections to the scapula, some- times along the ureter as far as the labia niajora. These neuralgias are usually confined to the affected side, more rarely they are transferred to the opposite side. Gueneau ~de Mussy observed intercostal neuralgia of the left side in a moveable kidney of the right side ; and among my observa- tions are two in which there was lumbar and intercostal neuralgia on the left side, the right kidney being moveable. On pressing firmly against the kidney, which is easily mani- pulated, both patients alike complain of circumscribed pain in the region of the opposite kidney.^ Menstruation produces increase of pain and impairment of the general comfort. We then observe the same phenomena «,s those described by Matthews Duncan under the name of aching kidney, these complaints consisting essentially of dull pain in the region of the kidney radiating thence into the bladder and sacrum. As a matter of fact this pain can almost constantly be found in women with moveable kidney at the menstrual period, even when they are free from it betweenwhiles. Whether it is induced more by menstrua- tion, or by the moveable kidney cannot now be decided. The fact, however, that it sometimes quite ceases after menstrua- tion and after the menopause, proves the existence of a ' [The same transference is sometimes observed in the case of tlie ovary.— Teanslatoe.]