On the Origin and Progress of Renal Surgery with Special Reference to Stone in the Kidney and Ureter, and to the Surgical Treatment of Calculous Anuri

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1898 Excerpt: ... at any rate, within a day or two. Thus it happens that authors have come to distinguish two stages in the progress of calculous anuria; namely, (1) the silent or tolerant period; and (2) the unemic period. But it is important to remember that death may occur as just mentioned without the supervention of the second or unemic period occurring. (1) Symptoms of the tolerant stage.--In the period of tolerance, the patient, though he may not pass a single drop of urine for several days, may yet walk about, eat, and do mental work in all the appearance of good health. This fact must never be forgotten, if a serious mistake in diagnosis and prognosis is to be avoided. It is, however, all the more likely to escape notice, because it is so opposed to the course of suppression due to non-obstructive causes. In the non-obstructive forms of suppression, e.g. in chronic, sub-acute, and acute forms of Bright's disease; in suppression from shock or collapse, as after severe internal injury, and in the algide stage of cholera or yellow fever; in all forms of inflammation and fever; and in the suppression of urine after slight operations on the urethra or bladder, death may occur within twelve or twenty-four hours. In these cases there will be symptoms of unemic poisoning, but death would seem to be too rapid to be explained simply by the non-elimination of urinary excreta. Moreover, if the suppression ceases, the return of the secretion is gradual, and the first quantities of urine secreted are scanty, albuminous, and perhaps bloody. On the other hand, in the calculous cases, the suppression of urine may last days, and if the anuria should cease temporarily, or permanently, free secretion is resumed; and the urine passed is of low specific gravity, and pale in colour; and ...