Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

325/440 (page 307)

Althongli however, no furfclier demonstration is needed to prove the impossibility of so marked an alternation between tense repletion and complete evacuation of the pelvis of the kidney as (Johnheim has assumed in the above cxjDosition ; the origin of hydronephrosis by means of mobility of the kidney as assumed by me contradicts this assertion. So little attention has liitlaerto been paid to the production of hydronephrosis by moveable kidney^ tliat Lancereaux, Troiisseau and others describe it only by the way as an occasional cause of moveable kidney^ and Gileioshi only mentions acute hydronephi-osis, and that in an erroneous connection with the symptoms of incarceration so-called. The reason of this is that the formation of tlie hydrone- phrosis entirely obliterates the primary causes, not only in their clinical relation, but also in tlieir anatomical appearances on dissection. In order therefore to establish my hypothesis, (that moveable kidney furnishes one of the chief causes of hydro- nephrosisj and that very many cases whose causes are con- sidered obscure are nothing- else than hydronephroses in moveable kidneys) not merely upon the above somewhat theoretical arguments, I shall here give additional proofs from the pathogenesis of hydronephrosis founded on patho- logical conditions, experiment, and clinical symptoms. (i) Proofs derived from the Pathogenesis of Hydronephrosis. That form of hydronejohrosis, in which no cause of com- pression or obstruction of the ureter is found after death, was known even to ancient writers. Sclwnlein (128) disagrees with the assertion of P. Franh Reports,' vol. xvi), treating of tlie diUitation o£ the ureters in Extroversion of tlio Bladder, the author's tlieory heing that of obstruction to the flow of urine by spasm of the vesical orifices of the ureters caused by irritation of the extroverted bladder. Similar urine is often secreted by children suffer- ing from incontinence, and is probably due to the same cause. In all these cases dilatation of the ureters and renal pelves is produced by the same cause, viz. a considerable but not absolute obstacle to the escape of urine.— Thanslatob.