Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

331/440 (page 313)

by tho frequent appearance and disappearance of a tumour, and which can be called (as Cole (143) and Moriis (144) have done), intermitting, or temporary, or relapsing hydro- nephrosis, has been described in moveable kidney by no one but Uger (145), so far as I can see. I myself have also seen a case in point (146), The refilling and disappearance of the hydrouephrotic sac could be repeatedly proved. In the woman especially on whom I operated, the torsion or valvular closure of the ureter was relieved by changes in posture and by diminution of the pressure of the hydrouephrotic fluid following moderate aspiration, the escape of the urine be- coming re-established. Both observations are appended below. The reason why intermittent hydronephrosis is so seldom observed may be that, as long as the alternation between rejDletion and evacuation goes on, the hydrouephrotic sac has still a small volume and therefore easily escajDOs recognition. But as soon as it becomes larger and more easily palpable, the valvular closure or the abnormal insertion of the ureter is generally so firmly established that the hydronephrosis remains permanent. Thus it happens that intermittent hydronephrosis in moveable kidney is often overlooked or otherwise interpreted. Tulpms (147) is the first to report on this peculiar form of ''ischuria, which he observed in a patient each time at full moon. It lasted in his case five days on each occasion, and only yielded to a venesection. He was unable to explain this peculiar condition during the life of the patient ■} Sola anatome, post obitum instituta, eruit illic feliciter veritatem in profundum demersam ; et ostendit distincte, qui angusta, renis sinistri, pelvis, excrevisset in earn amplitudinem, ut suppleret commode vicem, vesicae urinariae.^ Quae propterea tam fuit vacua, quam ren repletus. Sauvages (148) described this form of retention of urine, connecting it also with the moon, i.e. with the Ischuria lunatica Tulpii.'^ ^ Johnson (149) observed in a woman pregnant for the eighth time a remarkably changeable condition of the urine, » The case is reported under tho heading Iscliuria lunatica and the original contains uuiariae —a misprint for urinariae.—Tx!.unslatoe.