Surgery.

Date:: [1913]

Catalogue details

Licence: In copyright

Credit: Surgery. Source: Wellcome Collection.

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Describe Essential Renal Ilcematuria. Essential renal luematuria is a condition characterised by attacks ol haemorrhage from one kidney. The etiology is very obscure. It may follow renal infection. In many cases patches of chronic nephritis are found in the affected kidney ; occasionally a congested renal papilla is the source of the bleeding. The clinical features are :— (а) Capricious attacks of haematuria, uninfluenced by movement and not benefited by rest. (б) During the attacks the urine is burgundy-coloured, and usually free from clots. (c) Bacteria are absent from the urine. (d) On palpation, the affected kidney is of normal size, and is not tender. (e) The haemorrhage is unilateral. (/) All other investigations are negative. Severe cases may require nephrotomy and if no cause be found nephrectomy may be justifiable. Describe Renal Calculi. The etiology of renal calculi is still obscure. Some factor must cause the precipitation of crystals which are normally present in the urine in supersaturated solution. The mere presence of crystals will not cause a calculus to form and it is possible that some abnormal substance forms a nucleus for the stone formation. Infection is not a cause of stone formation but in most cases follows the calculus. Concen- tration of the urine and vitamin deficienc}'- have been advanced as an explanation of the frequency of stone in the tropics. Once a stone has begun to form its composition depends on the acidity or alkalinity of the urine and mixed stones will result when the urinary reaction changes during their forma- tion. In acid urine (a) uric acid, (b) urate, (c) oxalate stones are common. Cystin stones are due to a metabolic factor and are a familial disease,’ they are found in acid urine. In alkaline urine phosphate stones are most frequent. i