Diseases of the urinary organs / [Henry Thompson].

  • Sir Henry Thompson, 1st Baronet
Date:
Between 1860 and 1869]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the urinary organs / [Henry Thompson]. Source: Wellcome Collection.

    12/210 page 330
    be purulent. Under the microscope renal casts may be found con- taining pus and blood-corpuscles. Sometimes total siippression oc- cm's. General signs of fever are present, as heat of skin, dry furred tongue, headache, thirst, quick and hard pulse. Anasarca often appears also, in cases suddenly occurring from exposure to cold; not commonly in cases of extension from the bladder. In the latter instances, suppm^ation in the substance of the kid- ney is to be dreaded; the symptoms are then more intense, there is great depression of the vital pov^^ers, and fatal coma often occurs by m-asmic poisoning. If pyelitis accompanies or supervenes on nephritis, there is also generally pain and retraction of the testicle on the affected side. As it is impossible to include in this work a history of all the renal and allied affections with which the Surgeon should be fami- liar, a few remarks will follow here on the differential diagnosis of nephritis, so as to illustrate the leading characters of those other diseases which might be confounded with it. The diagnosis is not generally difficult, although in a few in- stances it may be obscure. If a patient, who has suffered long from urethral or vesical disease, or who has recently undergone an operation for stone or stricture, suddenly shows signs of an acute febrile invasion, with vomiting, pain and tenderness in the renal region, scanty urine, or urine mixed with blood, there can be little doubt of the presence of acute nephritis. When there is no history of previous urinary complaints, an attack of primary acute nephritis may sometimes be confounded with the following affections : calcu- lous nephralgia; pyelitis, simple and calculous; perinephritis; peri- neplu'itic abscess; spinal disease, or abscess of the psoas or adjacent parts ; lumbago ; renal neuralgia and hysteria; inflammation of the bladder; vesical calculus. 1. Calculous nephralgia; by which is intended the pain and systemic disturbance occasioned by the descent of a calculus from the kidney to the bladder, and which sometimes resembles very closely acute nephritis. Indeed, excepting only the severe febrile tsymptoms, all those of neplu'itis are present. There is acute pain, generally limited to one side, and shooting along the loins to the sacrum, with retracted testicle; but the invasion is more sudden, and the pain more acute, than in nephritis. There may be vomiting, frequent micturition, and bloody urine; but the constitutional dis- turbance, although it may sometimes be present in moderate degree, certainly falls short of the fever which always accompanies the inflammatory affection. If the calculus obstructs the pelvis or
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