Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

315/440 (page 297)

No inflammatory processes were remarked. The ligatured kidney usually became rapidly smaller after the sixth day^ and very soon returned to its former size. In some cases the ligatured kidney became atrophied after some weeks. Cohnheim (ii6) observes that when the renal vein is tied, the kidney swells up so rapidly from obstruction to the return of blood and from the supervention of oedema, that in less than an hour it may be twice as heavy and big as the other. Just as in the experiment, we find clinically in human beings a sudden onset of the symptoms of incarceration so- called ; in them also there developes in a very short time a tumour sometimes twice as large as the kidney itself, undis- tinguishable by the most accurate palpation from the kidney, and generally disappearing without leaving a trace in six or eight days. Again, the symptoms furnished by the secretion of urine tally with those in the experiment; in men as well as in animals under experiment at the beginning of the attack a dark urine, sometimes containing blood, and scanty for the first few days, is secreted, which does not become replaced by a profuse clear watery urine till recovery has set in. Inasmuch as the function of the affected kidney is naturally impaired when the renal vein is obstructed, or even as soon as its calibre is narrowed (as Robinson (117), Perls and Weissgerher (118) found), the quantity of urine of course diminishes at once. The subjective symptoms are likewise very easily explained by this hypothesis, since, when one kidney suddenly ceases to act the other does not at once supply its function, so that for a short time slight symptoms of uraemia are produced. The favourable issue lastly tells in favour of my hypothesis; for in animals, even after complete ligature of the renal vein, we see the kidney recover its function completely by means of the establishment of a collateral circulation, to which the vasa aberrantia which are often present, and the veins of the capsule of the kidney and of the supra-renal bodies con- tribute. It is difficult in an individual case to decide from the gravity of the symptoms, whether we have to deal with