Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

350/440 (page 332)

X. PfiOUNOSIS. The prognosis of uncomplicated moveable kidney is favourable as far as life is concerned. No case has been hitherto recorded in the literature of the subject in which death could be oven probably attributed to it. The fatal case quoted by Keppler (179) can hardly be regarded as a proof that an uncomplicated moveable kidney can cause -death. Still more must the assertion of Keppler (180)—that Moveable kidney, even vyithout any complications at all, gives rise to slow but continually developing disturbances of nutrition, which, as time goes on, infallibly undermine the health and even, life —be rejected as quite unproven; and we can only agree with Trousseau (181) who—referring to the treatment of moveable kidney by leeches, venesection, and still more questionable measures—expressed his opinion as follows : Le pronostic du rein deplace n'a vraiment pas de gravite ; il ne devient grave que par les erreurs aux quelles il peut donner naissauce, et le traitement errone qui en decoule ■est ordinairement d'autant plus actif que le medecin est moins -convaincu. The prognosis of uncomplicated moveable kidney has however grown, decidedly worse since men have begun to remove healthy moveable kidneys, basing their practice on the view set forth by Keppler. Of course some of the patients (who otherwise would not have been killed by the moveable kidney which gave occasion, to the operation) now pay for this with their lives. Spontaneous cures of moveable kidneys are commoner, especially in cases of acute traumatic dislocation, and they have been observed in cases in which emaciation following .acute febrile affections occasioned the mobility of the kidney. BoUet (182) gave a correct explanation of this when he said that when the kidney is put back into its normal position and kept there by suitable means such as quiet decubitus, the stretched subperitoneal cellular tissue around the kidney and against the posterior wall of the abdomen, as well as the peritoneum itself, gains time to contract more firmly by