On cystic entozoa in the human kidney : with an illustrative case / by T. Herbert Barker.

  • Barker, T. Herbert (Thomas Herbert), 1814-1865.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: On cystic entozoa in the human kidney : with an illustrative case / by T. Herbert Barker. Source: Wellcome Collection.

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

    11/20 (page 11)
    for some time most unsatisfactorily treated by anotlier practitioner. Slie complained of acute pain in the right side Just below the mar- gin of the ribs; she described the pain as of a severe character at one moment, whilst at another time it was more obtuse, of a forcing character. She suffered from almost constant sickness, and could not bear pressure either on the side or scrobiculus cordis. From the trifling examination she was able to bear, and from the quantity and character of the secretions, I thought the case might be one of biliary obstruction, and therefore prescribed mercurial purga- tives, with empl. lyttaa. I could only detect a trifling enlarge- ment in the side affected. In a day or two, having been much relieved of the pain and sickness, she left her bed and took to her ordinary occupation: the following day she had much difficulty in passing her urine, Avhich had been for some days less copiously secreted, and she observed that it was slightly opaque when passed, and contained flakes of membrane. On examining these flakes, I immediately detected several portions of the cysts of large hydatids, whilst numbers of smaller ones floated in the urine. These latter were entire, and varied from the size of a pin's head to that of an ordinary grape. They were perfectly unconnected to each other. From the size of the fragments which had been passed, I should consider that some of the large ones had equalled the size of an egg. The patient now seemed tolerably well, and I left off my attendance, having satisfactorily explained to her the nature of her case, and that she would scarcely be fortunate enough to escape a repetition of the disorder. In February, 1848, she again sent for me, but I fancied that she had rather antici- pated an attack, as she got well without anything unusual occur- ring. In February, 1850, I was again called in, and found her suffering from very severe pain in the side. I now imperatively carried out my examination, and detected a lobulated tumour, measuring, as felt through the abdominal integuments, about 8 inches by 4 in breadth and thickness, immediately in the region of the right kidney. I prescribed anodyne and demulcent medi- cines, and in a day or two the tumour gradually dispersed, the pain, at the same time, subsiding. The following day a large quantity (many hundreds) of hydatids made their appearance. In May, 1851, she had another attack, but passed only a few small ones. She relapsed again in March, 1853, also in February, 1854, as well as in the following July. At the last-named period she passed a large number, some of considerable size, one of which so obstructed the urethra as to require manual removal, The tumour in the side had entirely subsided, and has not at present (November, 1855) reappeared. From the foregoing notes there can be no doubt as to tiie nature of the case—the only question IS as to locality. If the hydatids had formed in the pelvis of the kidney, would they not have been earlier destroyed by the action of the urme; or, if not, could they have produced the lobulated