Diseases of the kidney which require surgical operation : illustrated by three cases / by W. Morrant Baker.
- William Morrant Baker
- Date:
- 1881
Licence: Public Domain Mark
Credit: Diseases of the kidney which require surgical operation : illustrated by three cases / by W. Morrant Baker. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![days it was obvious that much improvement in the general condition of the patient had resulted from it. The quantity of pus in the urine had diminished, though by only about one-half of its previous amount. The ligatures were found loose in the wound on the ninth day after the operation. A slow but steady improvement in the condition of the patient has continued since this date, and on April 20 (two months after the operation) it is noted that the child eats and sleeps well, that she has no pain, and that she looks better and is in much better spirits than formerly. She has gained slightly in weight. The amount of pus in the urine is less than half of what it was before the operation. On one occasion it has contained a little blood. The wound is looking healthy and healing soundly from the bottom. The notes of July 15, 1881, record that at this date—five months after the removal of the kidney—a most marked improvement in every way is perceptible The child has gained in colour, flesh, and strength, is much more lively, and plays about all day long, frequently going out of doors for a walk. The appetite is good, and she sleeps well. The temperature ranges between 98° and 99° F. The wound is slowly cicatrising from the edges, and is now about a quarter of an inch only in width. There are still a few sinuses about a quarter of an inch in depth, leading off from the main wound. The quantity of pus in the urine is less. At the present date it averages about kalf-an-ounce a day. Six weeks ago it was three-quarters of an ounce. Occasionally, a little blood is passed in the urine, and this is usually accompanied by some pain in the region of the bladder. The total amount of urine passed is about lialf-a-pint a day. Case II.—A case of Nephrotomy.—[For the details of the notes I am indebted to Mr. Hewer, Surgical Dresser.] The patient, a lad sixteen years old, was admitted into St. Bartholomew’s Hospital, February 26, 1881, under my care, on account of a large swelling in the region of the left kidney. He had been for some time previously under the care of Dr. Dyce Duckworth. He was in perfect health until about four years before admission into the hospital, when his illness began with a sudden sharp pain, in the left renal region, which obliged him to go home and lie in bed. By the next morning, however, the pain had ceased, and he was as well as ever. A second attack, with like symptoms, occurred a fortnight after- wards ; and, subsequently, attacks came on at almost uniform intervals of a week, and these have continued to the date of his admission into the hospital; the attacks lasting usually from eight to sixteen hours, and the pain being very acute and always felt in the same region—that of the left kidney. During an attack a large swelling, fluctuating to pressure, has been perceptible on examination in the painful region. The swelling has however, subsided soon afterwards, and no trace of it can be discovered until the onset of a fresh attack. Before an attack it is said the urine is clear; immediately afterwards it becomes thick with pus, the thickness then again disappearing gradually, and the urine remaining clear until the patient has suffered from another onset of pain. During an attack he always lies on his back, with the knees drawn up; and while the pain lasts he is said to take no food, nor does he pass urine, even when the attack is prolonged for many hours. In June, 1879, he was admitted into a medical ward, under the care of Dr. Andrew, and remained there for two months, but without permanent benefit; the attacks of pain and the accompanying symptoms appearing with great regularity.](https://iiif.wellcomecollection.org/image/b2245925x_0008.jp2/full/800%2C/0/default.jpg)
