Nephrotomy for calculus pyelitis : nephrectomy rightly decided against because of the small percentage of urea, an apparently almost destroyed and useless kidney found to secrete over four and a half times as much urine as the other kidney, death.

  • William Williams Keen
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: Nephrotomy for calculus pyelitis : nephrectomy rightly decided against because of the small percentage of urea, an apparently almost destroyed and useless kidney found to secrete over four and a half times as much urine as the other kidney, death. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    towards the epigastrium and towards, but not into, the bladder. The attacks were accom- panied with a desire to urinate, and the urine at this time was high-colored but clear, con- taining no deposit. Her general health was good. During the latter part of last August she had what she called chills and fever, and co- existent with this development the pain in the loin became constant and remained so. She had no night-sweats. The chills were probably septic. Dr. Stewart first saw her on December 3, 1890 ; she had then been in bed for three weeks. She was very dyspeptic and consti- pated. Her temperature did not rise above 100° F. The urine at this time was normal in amount, and when lithia-water had been taken, had sometimes run up to two quarts. In an eight-ounce bottle of urine there was about half an inch of sediment. The urine was ex- amined, frequently under the microscope, and found to consist chiefly of pus ; in addition, there were some lafge cells, probably from the pelvis of the kidney or from the ureter, and considerable squamous epithelium, probably from the bladder or vagina. There were some red blood-cells, and on two occasions granular and hyaline casts were found. In the later specimens there was also a little uric acid, but no oxalates. The urine was always acid, even after standing three or four days. The amount of albumen was in proportion to the amount of pus. Tubercle bacilli were repeatedly searched for by Dr. Stewart, with negative result. There was always tenderness on pressure,
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