The thorax, the organs of digestion, the genito-urinary organs (Google eBook)

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Sir Frederick Treves
Lea Brothers & Co., 1892
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Page 511 - In one case of communication of the left kidney with the stomach, pus, urine, and calculi are said to have been vomited ; but there is a considerable degree of uncertainty as to the genuineness of the symptoms and accuracy of diagnosis. In a case of gastro-renal fistula due to scrofulous pyelo-nephritis, admitted under the writer into the Middlesex Hospital in 1884, there was a history of "inflammation of the bladder" and of "pus in the motions,' as well as in the urine. There were four sinuses in...
Page 516 - In the early stages, the symptoms are those excited by the cause of obstruction, whatever that may be ; and in addition those of pyelitis. If the obstruction be not complete, there will be pus in the urine ; if intermittent, there will be intervals during which no pus is discharged ; if complete and permanent, there will be an entire absence of pus in the urine. There will be constitutional symptoms of suppuration, and when the pyelitis is very chronic, all the characters of hectic. When a tumour...
Page 532 - ... likely to be confused. (A) From enlargements of the liver. Renal tumours often dip down or fade off so as to allow the fingers to be depressed between the edge of the costal cartilages and the upper border of the tumour. Hepatic tumours pass downwards from beneath the ribs, and so rarely do they have any intestine in front of them, that the presence of bowel in front of a tumour may be regarded as a strong indication that it has not its origin in the liver. When the...
Page 258 - As the effect of forcible and long-sustained compression of the hernial tumour, the delicate serous membrane of the sac is rent, burst, or torn, and the hernia makes its escape through the aperture into the subserous connective tissue. Its course outside the peritoneal sac is advanced by continued pressure ; and detaching the connections of the neighbouring peritonaeum, it forms for itself a pouch between that serous membrane and the internal abdominal fascia.
Page 509 - Traumatic nephritis is not usually serious, provided the damage inflicted on the kidney is not great and the large vessels are not ruptured. If severe, the kidney may be softened down into a mere pulp. Treatment. If the kidney has been penetrated, urine will drain away by the external wound. If the organ has been opened by subparietal laceration or rupture, the chief danger when the large vessels are uninjured is from infiltration of urine into the cellular tissue. Then it may be necessary to...
Page 531 - ... 6. When the pelvis of the kidney is dilated, the resulting tumor may press upon the liver so as to be indistinguishable from it; it may, and often does, reach down into the iliac fossa; and occasionally it extends inward beyond the middle line of the abdomen. I have opened an hydronephrotic swelling which crossed the linea alba fully two inches. As a rule, however, renal enlargements never invade the pelvis, rarely reach the median line, and frequently are separated from the hepatic dullness...
Page 280 - The disease seldom occurs in childhood, but usually in earlj' adult or middle life; it is more common in women than in men, and often appears to have been induced by pregnancy or parturition.
Page 512 - ... both kidneys, or only one, or may be limited to only a part of one kidney. Cases of double hydronephrosis are commonly of congenital origin. The proportion of cases in which hydro-nephrosis produces a palpable abdominal tumour is very small compared with the frequency of the existence of the disease. Pathology. The pelvis of the kidney first becomes converted into a spheroidal sac, then the calyces are widened and stretched in every direction, and at length the capsule of the organ is expanded,...
Page 520 - Vesical haemorrhage is improbable, because, the bladder being a collapsing organ, the mucous surfaces fall together and receive some support from the surrounding viscera. That the haemorrhage in such cases as we are considering comes from the congested vessels of the kidney, and is not due to cancer, calculus, tubercle, etc., the history and mode of onset of the bleeding will in most cases clearly show. Prognosis. This must always be serious in old men with prostatic trouble, or in young men...
Page 322 - The source of the troublesome affection is to be sought both in general and local causes, or in combination of the two. Among the local causes minute threadworms are common, and occasionally pediculi are present, while a vegetable parasite causing eczema marginatum' is sometimes the source of irritation. Internal piles are the occasional cause of pruritus. Indeed, eczema of the part is a frequent complication of pruritus. In other cases the general constitutional condition plays a more important...

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