Volume 1

Diseases of the kidney and urinary derangements / by W. Howship Dickinson.

  • Dickinson, W. Howship (William Howship), 1832-1913.
Date:
1875-1885
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidney and urinary derangements / by W. Howship Dickinson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    63/736 (page 663)
    6(33 Pain may travel up the ureters, as in the cases referred General to, and become fixed ia the lumbar regions, as dull or ■'^^''P*^'^™^- weighty; but in many instances and for long periods there is nq^pain at all, or only what must be attributed to the disease in which the pyelitis has arisen. If the exit is free there will be no such tumour as can be appreciated from without, except, as sometimes in the case of tubercle the original disease be attended with this degree of tu- mefaction. If the ureter be closed the swelling may be. felt from before and behind, more often as a small than as a large renal tumour. Such are detailed too fully elsewhere to need descript ion here. There may be at the beginning a discharge of mucus or of blood, and the latter may be repeated at intervals throughout the course of the disease, particularly if associated with stone, and sometimes if with tubercle. More charac- Changes in teristic is the persistent, or persistently recurring, dis- charge of pus with the urine, together with evidence that it is derived from the pelvis, or, what may be equivalent, that it is not derived from the bladder. If the exit is unimpeded the pus is 'laudable' and inoffensive; on standing, it separates somewhat abruptly from the urine, which retains its acidity. It has been stated so fre- quently that a discharge from the pelvis of the kidney can be distinguished by the epithelial cells which are shed with it that I almost hesitate to assert, what 1 have taken Pelvic some trouble to ascertain, that there are no characters by ,?ouli's'' which detached cells of pelvic epithelium can be positively t'nguish- recogiiised, however practicable it might be to distinguish the pelvic membrane could it be seen in mass. Eoberts describes the epithelium shed as the result of^ pyelitis as being 'very irregular, spindle-shaped, tailed, three-cornered, elongated, rudely circular, etc.,' and as thus a.ffording certain evidence of its origin. It will be seen, however, that these varieties of form, even to the ' e/c.,' are equally characteristic of vesical disease. Ebstein ia ' Ziemssen's CycloiDBodia,' describes the pelvic epi- thelium as characteristic in virtue of its shapes—'flattened, X X 2