Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

319/440 (page 301)

301! JEhrle (123) in Niemeyer's clinique, who, without any cogent reason, assumed a stone in the kidney as the cause of the hasmaturia. In the same way Rollet (124) mentions a case- o£ left-sided displacement of the kidney in Oppoher's clinique, in which the urine was passed with pain and contained blood. I myself have frequently been able to prove the presence of blood in the urine, especially when the patients complained of considei-able pain in the region of the kidney. But we have already become acquainted with the most intense form of disturbance in the secretion of urine, in the form of sup- pression caused by venous engorgement, when considering the symptoms of renal incarceration so-called. If we recall the kinks and twists of the renal vessels,, especially the vein, which inevitably follow displacement and rotation of the moveable kidney, we shall be compelled tO' regard the symptoms described as also dependent on local disturbances of circulation, and to a certain extent as the first, and certainly often very transitory, stage of renal in- carceration so-called. It will depend on the duration and degree of interruption to the circulation in the renal vein, whether in any individual case we have to deal with a sup- pression of urine of short duration, or a more or less copious- discharge of red-blood corpuscles, or finally with regular h£ematuria or epithelial denudation, and subsequent pyelitis.. The instructive experiments of Perls and Weissgerher and of Bobinson^ already mentioned, who found exactly the same changes as those above-named in the secretion and excretion of urine in the animals under experiment, point in the same direction, namely, that here an obstruction to the circulation in the renal vein takes place. In the same way frequent impediment as well as total obstruction to the circulation in the renal vein is capable of producing atrophy of the kidney. Whether such local disturbances in the circulation may also lead to parenchymatous nephritis, as Frerichs (125) and Leudet (126) imagine, must remain an open question. By far the most important disturbances however take place with reference to the excretion of the urine. We have already seen that this is disordered even by local distui-bance of circulation in the vessels, and this is confirmed by » [ Robertson in the text. But see p. 297.—Teanslatoe.]