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
Catalogue details

Licence: Public Domain Mark

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.

    292/440 (page 274)
    sional occurvcnce of isolated ruptures of the capsule of the kidney by a blow or its “ coutrecoupwill not be doubted. I nayself have seen two patients in whom careful investigation proved tbe sudden appearance of an abdominal tumour, in one case after carrying a heavy weight with the trunk bent sideways, and in the other case after a fall, in both cases without any predisposing anatomical cause. In a similar fashion other authors have seen moveable kidneys actually develop in the course of labour after severe bearing down ; but in these cases it is questionable whether a moveable kidney already produced had not been pushed up during pregnancy by the growth of the uterus, and merely reappeared after delivery. This complaint, however, is more frequently induced by repeated injury, especially by the shock of cough in bronchitis, pleurisy, whooping-cough, and particularly when favoured by other factors, such as the rapid emaciation of phthisis. Even Riolan and Portal drew attention to the importance of this influence, and they have been confirmed by the obser- vations of Le Ray, Defontaine, Olivier, Keppler, and Rayer. I myself cannot doubt, when I consider that the kidney lies above the lowest part of the jileura, that every pleurisy with effusion must necessarily depress the kidney, so that under these circumstances, violent concussion of the diaphragm may very easily produce mobility of the kidney. But repeated exertions, such as prolonged and severe labour, lifting great weights, cari’ying heavy children, violent straining at stool, may act in the same way as fits of cough- ing in loosening the attachments of the kidney and thus contributing to its mobility.’’ Litei'ature contains many vouchers for their occurrence. Thus a patient under my care, in whom no predisposing anatomical cause of moveable kidney could be ascertained, had been used to carry heavy bui’dens on the hips, with the trunk bent sideways. * [The steady squeeze, presumably equal in all directions, produced by any of the above methods is surely a very dilferont thing from shocks, such as that of coughing, blows, or falls. This has been remarked in a previous note—Teaxslatoe.] ^ [This unsymmetrical position may have been a very important factor in the case.—Tuaxslaxoe.]