Selected monographs : comprising Albuminuria in health and disease ... Some considerations on the nature and pathology of typhus and typhoid fever ... Moveable kidney in women.

Date:: 1884

Credit: Selected monographs : comprising Albuminuria in health and disease ... Some considerations on the nature and pathology of typhus and typhoid fever ... Moveable kidney in women. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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$ureters by traction (such as may be produced by stretclimg an india-rubber tube) higher up than the point of application of the traction, as can be seen in Virchow’s case.^ Physical causes. We have so far studied the primary changes in the direct or indirect means of fixation of the kidney as pi edu- cing its mobility, but in all cases pressure from above or traction from below must contribute to its development. These 'physical influences are competent, by themselves and xvithout any previous anatomical changes of importance, to produce moveable kidney. Thus acute injury is frequently cited as a cause. In this case, of course, just as in cancer of the breast, the bare state- ment of the patient that a tumour developed in the abdomen after a fall or a blow, &c., should not be implicitly believed. In the case of moveable kidney as well as in cancer of the breast, it is an external occurrence which flrst directs a jiatient’s attention to the existence of the malady. The oc- currence of this luccatio traumatica renis is established by trustworthy observations. Thus observations are quoted by Payer, Henoch, Ferher and Le Pay, in which this complaint was acutely produced by a fall from a carriage or from horseback, or by a blow on the side. If it is remembered that isolated ruptures of the liver, spleen or kidney have been found after severe injuries, the possibility of the occa- ^ [Attention should be called in this place to a remarkable class of cases in which marked dilatation of the ureters and hydronephi’osis occur. These may be described as cases of urinaiy obstruction from irritation. The first division of the class concerns the subjects of incontinence of iirine. Three cases are recorded by X>?-. Alexander James, ‘ Edinburgh Medical Journal,’ 1878, p. 135, in which death occurred, and in the two of these in wliich a post-mortem examination was obtained dilatation of the ureters and double hydronephrosis was found. The second division concems the subjects of extroversion of the bladder, in which affection a similar condition is gene- rally found {Champneys, ‘ St. Bartholomew’s Hospital Ecports,’ vol. xvi, 1880, p. Ill) in spite of the absence of any structural obstruction to the ureters. In botli of these cases the obstruction is spasmodic, and the com- parison of the two classes shows that its seat must bo the orifices of the ureters. The bearings of this on the previous remarks in tlie text are obvious.—Teanslatob.] 18$