Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

307/440 (page 289)

assumption that as cases in point are collected we shall have to recognise this as an additional cause of jaundice. Although I have seen jaundice supervene on three occa- sions in women afPected with moveable kidney (in one of them four times within a short space,, lasting on each occasion a few days), I cannot regard these cases as a clinical proof of temporary compression of the common bile duct, as this is impossible for the same reasons as the direct compression of the duodenum. How, moreover, can we explain an isolated compression of the common bile duct which opens on the left side of the duodenum by a moveable and not fixed kidney on the right side ! I am much more inclined to refer the frequent appearance and disappearance of the jaundice, which I also saw in my case, to a temporary occlusion of the duct by mucus or a gall stone, particularly as this peculiar appearance and disappearance of jaundice is not a very rare occurrence even among women who are not the subjects of moveable kidney, as I have often had occasion to observe. It is, however, certain that women who have moveable kidney are more prone than others to jaundice, but only because they more frequently suffer from gastro-duodenal catarrh, for the reasons above enumerated, and because a move- able kidney not infrequently contracts adhesions to the gall- bladder. Thus, in a case observed by me (see below), in which there was jaundice which persisted several weeks, the cause for the jaundice appeared to be connected with a firm adhesion between the moveable kidney and the lower surface of the liver and gall-bladder (mit dem unteren Leber- lappen und der Gallenblase). Still more serious disturbances are said to be produced by moveable kidney through compression and consequent obstruction of the colon. Rollet relates a case in Oppolzer's clinique of a woman, twenty-six years of age, and apparently consumptive, who had a moveable kidney, and who had suffered many years previously from small-pox, later from enteric fever, and in early years had been in the habit of masturbating. Inasmuch as she in the meantime, up to six months previously, had suffered (especially after bodily exer- tion such as dancing) from, violent colic, and since her admission into the hospital had frequently suffered from 19