Remarks on cases of renal surgery / by Sir William Stokes.

  • Stokes, Sir William, 1839-1900.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on cases of renal surgery / by Sir William Stokes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    found him sitting up in bed with the bedclothes all tossed about him, and a look of intense agony on his face. His pupils were dilated, and large beads of perspiration were on the forehead and nose. His legs were drawn up, and his arms crossed, and pressed tightly against his abdomen. At times he screamed from the agony he endured, and then imploringly besought for anything that could give relief. These attacks of pain were spasmodic in character, and were referred chiefly to the right hypochondriac and umbilical areas, with short intervals of apparently com- plete relief. During the attacks of pain he would some- times roll out of the bed and lie on the floor groaning, and at other times roam about the ward seeking by change of position to relieve the pain, often exclaiming that it would kill him. He got little or no sleep at night, notwithstanding the administration of powerful anodynes, which had little or no effect. The urine on examination was found to be normal. The bowels were, and had been for some time, very costive. The treatment consisted at first in the exhibition of purgatives and anodynes. Turpentine enemas, calomel, hypodermic injections, bromides, Indian hemp, lupuliu, chloral hydrate, belladonna, magnesia, ox gall, &c., were all tried, but at all events without any but a very transient beneficial effect. The case was then transferred to the surgical wards and placed under my care, when it was seen by me for the first time. The history, symptoms and emaciated con- dition of the patient made me first suspect that the case, was one of a malignant tumour of the omentum or transverse colon, or both. Another view that was taken was that it was one of faecal impaction; another that it was a wandering spleen or a movable or floating kidney. One thing at all events was clear to me, and that was that the case was one for an exploratory laparotomy, but as there was so much obscurity and difference of opinion about the case, before undertaking any operation I brought it down to the Biological Club, when the opinion I had formed that it probably was renal was much strengthened, more particularly by the views expressed on that occasion by Dr. Macan. Accordingly on November 13 I opened the abdomen of an incision about four and a half inches in length along the outer border of the right rectus muscle with its centre corresponding to the