Licence: Public Domain Mark
Credit: The surgery of the kidneys. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![of left renal colic ; other attacks followed—one in February, two in ]\Iarch, one in April, two in May, and a very severe one towards the end of June. All were typical of left renal colic, no pain or uneasiness ever being complained of in the right side. I fully agreed with Dr. Johnson that it was a proper case for operation, as did Dr. Coupland, who had also seen the child, and who was present with Dr. Johnson at the operation. Dr. Johnson also agreed with the reasons which I urged in favour of my combined abdominal and lumbar operation, to be hereafter described, being adopted in preference to a simple lumbar incision. On August 4th, iSS6, Mr. Murray administered chloroform, and assisted by INIr. Malcolm, I made the usual lateral abdominal incision over the left kidney. The most careful examination failed to detect anything wrong either with the kidney or ureter, beyond a few minute superficial cysts on the surface of the former. I therefore passed my hand across to the other side of the abdomen, and found that the enlargement of the right kidney which we had detected, was due to its pelvis and calyces being packtd with these large stones, which I show you. I made my usual loin incision, and removed them. The patient made an excellent recovery, and remains in good health, having no further trouble in her left side, beyond a very short attack of colic just when she first began to move about, pro- bably due to some stretching of adhesions in the right side. Con- cerning this single recurrence, her father wrote, that during the attack she would not admit to pain over either kidney or ureter, but that when it had passed off next morning, she was distinctly tender on pressure over the left loin. Did time and space permit, I could give you notes of other cases, in which this transference of pain is quite distinctly shown by the unfailing test of operative examina- tion. Sometimes a careful examination, by combined lumbar and abdominal pressure, will reveal the actual presence of a stone as a hard projection from the surface of the kidney, but this is only possible when the stone is large, and the patient thin, with a lax abdominal wall. When all the symptoms of stone are](https://iiif.wellcomecollection.org/image/b21205796_0040.jp2/full/800%2C/0/default.jpg)
