Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

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prolonged suckling, or generative affections of all sorts Lave preceded or still persist, we are hardly justified in calling moveable kidney tlie cause of tke gastric disturbances. A primary chronic gastro-intestinal catarrh or a gastric ulcer may, however, so impair nutrition that these affections may be justly regarded as furnishing a cause for the mobility of the kidney, rather than as being themselves caused thereby When, therefore, Kepphr attributes the disturbances of nutrition, emaciation, even death to a moveable kiduey, it is -necessary for us to be emphatically warnecl against these practically injurious exaggerations, as has been done by 'Oerum-Eowitz with reference to the cases described by Keppler. The real ill-consequences of moveable kidney, •even in its bearings on the digestive tract, are only obscured loj such performances. As a matter of fact moveable kidney may contribute to gastric disturbances, as might be assumed beforehand from the nervous and vascular connections between the renal and other abdominal organs. This connection is completely con- firmed by clinical observation, inasmuch as persons with moveable kidney experience epigastric pains and digestive ■disturbances whicb are otherwise inexplicable. It is often possible by pressing on the prolapsed kidney to produce epigastric pain, nausea, and retching, in these patients, to reproduce in short exactly the same condition which they will tell you unasked is that from which they are suffering. A very plausible theory has lately been suggested by Battels, of Kiel, to explain the frequent coincidence of dila- tation of the stomach and subsequent gastric and intestinal catarrh with moveable kidney on the right side. According to this, the right kidney displaced forwards and inwards by the pressure of tight lacing (as described by ITw.Wer-TFaniec/c (107) ) compresses the fixed descending portion of the duo- denum which lies between the hilum of the right kidney and the vertebral column, and thus produces a mechanical obstacle to the escape of the chyme from the pylorus, aud dilatation of the stomach with its well known consequences. Oser (ro8) has rightly opposed this hypothesis, and espe- cially on clinical grounds. He thinks it is self-evident that