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 usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1898 edition. Excerpt: ...of the secretion of the- urine, that operative treatment is most likely to succeed. An early operation in such cases would lead to the discovery and removal of the cause of the hydronephrosis, as well as of the anuria, and would save the kidney from progressive degeneration, and the patient from fatal suppression of urine. The fact that the opposite kidney is functionless and destroyed is an additional reason for operating, not a contraindication for so doing, as it is too often considered to be. It was so regarded in the case of my patient, yet the actual result of the operation was all that could be desired. (Table I., No. 34.) (2) Symptoms of the nrcemic stage.--At a variable period the second or uraemic stage sets in. When the anuria is complete this period arrives mostly about the seventh or eighth day. For a time no doubt the poisoned state of the circulation is relieved by the supplementary elimination through the skin, lungs, and digestive mucous membrane. But sooner or later these organs are insufficient for the task, and themselves become vitiated by the unaccustomed functions they are called upon to perform; then the blood becomes surcharged, and in turn the nervous system comes under the influence of the uneliminated poison. But why this effect is so much more tardily produced in calculous anuria than in non-obstructive uraemia is not known. The symptoms of the uroemic stage may be summarised under three groups (a) the circulatory, (b) those connected with elimination, and (c) those of poisoning. (a) The pulse is slow and full and later becomes irregular. Epistaxis in one case was very abundant; oedema about the malleoli and even a true anasarca--the result of venous stasis, not of albuminuria--have been observed in a...