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.

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    Taking tlie analogy of a strangulated^ licrnia the symptoms consequent on incarceration of tlie kidney have been explained in this bearing also by the supposition of a circumscribed peritonitis. This idea has been strengthened by tlie resem- blance of the clinical symptoms to those of circumscribed peritonitis due to other causes, such as perimetritis and peri- typhilitis, by the supervention of great distention, Avbicb was taken for effusion, and finally by the fact now and then obsei’ved that during' and after an attack the mobility of the kidney is restricted. The invariably favourable course, however, of tbis supposed peritonitis with effusion, as well as the cii’cumstauce that the effusion, Avhich is sometimes “ euormous,^^ disappears in from six to eight days, cannot fail to throw doubt on the correct- ness of this explanation. Besides, the peculiar outline of impaired resonance which is found diffused around the move- able kidney, does not admit of easy explanation on the assump- tion of circumscribed peritonitis. The opinion of Qileiuski that acute hydronephrosis produced by incarceration of the kidney constitutes the essence of the process under discussion, appears again unlikely, inasmuch as the weight of a noi’mal kidney is far too small to be able to overcome by its pressure the pressure under which the urine is secreted into the ureter ; besides an acute hydrone- phrosis is not competent to distend the pelvis of the kidney to the size found in those cases, and, moreover, it does not, as we knoAv from numerous experiments, produce the sym- ptoms we have named. A dog whose ureter has been tied, secretes, as Gohnheim (iii) says (when the operation is not followed by inflammatiou, the general health remains unim- paired and the same food is taken), the same quantity of urine and that of the same specific gravity as before. And this not only in the first days and weeks after the operation, but also later, when the occluded kidney is attacked by * [Great diflieulty has been felt in clccidiug between “strangulation” and “ incarceration ” as the equivalent of “ Einkleminungbut the latter woid has been chosen, as tallying best with the facts, as a word used synony- mously with Einldemmung frequently in the text, especially in connection with the name of Dictly the author of the term. Eut, in the present passage, the reference is obviously to the general class of Strangulated Hernia.— Tli.VNSLATOll.]