Diagnosis of renal calculus in women / by Howard A. Kelly.

  • Howard Atwood Kelly
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Diagnosis of renal calculus in women / by Howard A. Kelly. 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.

    4/12 (page 4)
    as to the amount of risk he incurs in operating upon one of the kidneys. He also knows what risk he runs in removing a crippled kidney, if he is tempted to do so by the amount of disease found. In addition to this indispensable means of diag- nosis, I have recently been able to add two other signs of absolute certainty that are applicable in a large number of cases of renai calculi. For the purpose of this examination I use renal catheters and renal bougies. The renal catheters vary in diameter from to 2mm., and are 50 cm. (20 in.) long. In all other respects they are like the ureteral catheters already spoken of. The catheter is used in the following way: The ureteral orifice is exposed and the catheter introduced, say No. 2 or 2]/^, and pushed gradually on upward until resistance to further advance is felt. In gen- eral about from 13 to 17 cm. (6 to 7 in.) of the catheter is left projecting from the urethra. Then taking an air-tight syringe with a tapering metallic point, and connecting it by means of a piece of fine rubber tubing with the end of the catheter, strong suction is exercised. If there is any pus present, this is often brought at once down into the syringe, and begins to flow long before it would naturally without suction. The suction is con- tinued until the renal pelvis is emptied, and the fluid obtained is placed in a conical graduate for careful examination. In three cases I have been able to diagnosticate the presence of renal calculi by discovering in this fluid a minute, dark-brownish or blackish sediment consisting of little pieces of material about a half-