Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

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which was either scanty ami dark or plentiful and milk- white ; m the first case its oxorotiou was accompanied by g-reat pain, in the last case it was easily passed. After delivery a largo tumour was noticed on the left side, pro- jectino- four inches above the surface of the abdomen, and measuring seven or eight inches in diameter. The tumour was tense and smooth over its whole surface ; on gentle palpation there was distinct fluctuation ; pressure on it caused pain. The diagnosis of an ovarian tumour was made. Soon after the patient died; the autopsy showed bilateral hydro- nephrosis. Schdnlein (150) distinguishes two varieties of renal dropsy (Hydrops renalis). In the first,, in which the ureters are per- vious, the patients pass an enormous quantity of pale greenish uriue, four to six quarts^ or more in the twenty-four hours. In the second variety, in which the ureter is closed, the urine passed is scanty, dark, and reddish; the tumour in the ■renal region and the sympathetic symptoms are much more plainly marked in the second than in the first. The dia- gnosis is very difiicult. The disease has not hitherto been recognised till after death, in several cases it has been taken for ovarian dropsy. Rosenstein (151) quotes a case of supposed hydroneplii'osis which, in consequence of the sudden disappearance of 'the tumour, he erroneously considers to have been an ovarian tumour, as he remarks : In cases where the development of the tumour is not observed, there will always be sources of error in diagnosis. The statement of the patient also, of occasional spontaneous evacuation through the bladder, is well worthy of consideration, as this is more likely to happen when an ovarian tumour is adherent to the ureter than in hydro- nephrosis, where the mechanical occlusioii occasioned by the hydi'onephrosis is hard to overcome.' UilliGr (152) relates the case of a woman who showed a tumour in the right side, which occasionally disappeared and then reappeared. As long as the tumour remained she had violent pain and the urine was scanty, as soon as it dis- ' A Maass is a German measure for beer, diJl'erenfc in tlillerent States. It seems to be about a pint on an average, but in this place must meau a larger quantity.—Tuanslatoe.