Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

308/440 (page 290)

obstinate constipation often lasting six or seven days, from frequent colic, swelling of the abdomen, retching, desire to vomit, and sensitiveness of the abdomen, the following diag- nosis was made : Intestinal obetruction, caused by pressure exercised by the kidney on the ascending colon. This case, however, is so far from proving obstruction of the colon by the kidney that it ought not to be let loose on literature without a query, until it is proved by an appropriate autopsy that the improbable assumption is true, viz. that the colon can be permanently compressed by a moveable kidney. The origin of such a compression in adhesions formed by the moveable kidney is not unlikely. Certain it is, however, that a moveable kidney is competent to produce (by mechan- ical injury and dragging on the bowels) colics and dull boring pains in the abdomen, which are not otherwise easily explic- able, and which we not infrequently find in patients with moveable kidney, without any other discoverable cause. The Symptoms of Renal Incarceration so-called. Patients with moveable kidney are subject, generally after violent exertion or rapid movement, to a sudden piercing pain in the abdomen, which forces them to lie down. Soon the whole abdomen becomes sensitive and distended, and the side (especially in the region of the prolapsed kidney) becomes painful on palpation. A profound feeling of general discomfort follows. The patient is weak, giddy, palpation of the renal region easily makes her faint, a cold sweat covers the brow, the pulse is small, the respiration superficial. Sometimes there is a desire to vomit, actual vomiting often supervenes. The urine is dark and scanty, often coloured red from the admixture of blood. The attack is not always ushered in by a rigor, in fact the pyrexia is slight throughout. The observer detects (as far as the tension, resistance, and tenderness of the abdominal walls allow him) in the region of the prolapsed kidney a large tumour, confined to the corresponding side, over which percussion is nnpan-ed, and which is hardly moveable. In the course of one or two weeks, however, this tumour