applied by the nurse and drawn tightly before she moves.
The masseuse is directed to avoid any movements which might further
displace the organ, and may cautiously push it upward and hold it there
with one hand while with the other the manipulation of the abdomen is
performed. However long it may require, the patient should not get up
until examinations, supine, lateral, prone, and erect, combine to assure
us that the kidney is replaced. Repeated investigation of this point
will be required,--for the kidney will sometimes be in place for a
little while and next day or even a few hours later have slipped down
again. Before any exertion is permitted, even ordinary walking, an
accurate close-fitting abdominal belt with a kidney-pad should be
applied. Those kept in stock are seldom properly adjusted, and usually
have the pad in the wrong place. If rightly made, they can be worn with
comfort and tight enough to be useful. If not rightly made, they are
useless instruments of torture.
Mrs. Y., aet. fifty-six, was sent to Dr. J.K. Mitchell by Professor Osler
for treatment. She had all the usual intestinal derangements and
discomforts attendant upon a floating kidney: constipation alternated
with diarrhoea, or rather with a sort of intestinal incontinence; vague
pains in the back, flanks, and stomach were frequent; attacks of acute
pain began in the right hypogastrium and ran down to the symphysis or
into the groin; she had constant flatulence, weight, and oppression
after food; was pale, flabby, and emaciated, but had no emotional or
nervous symptoms except an annoying amount of insomnia. The lower border
of the stomach was fully two inches below the navel in the middle-line,
even when only a glass of water had been taken. It was a little lower
after a small meal. The colon was distended and very variable in
position, probably changing its relations with the landmarks as it
happened to be more or less filled with food or gases. The abdominal
walls were flabby, relaxed, and pendulous, and the whole surface tender.
The patient gave a history of sudden loss of flesh with almost no
reason some three years before, and increasing indigestion in all forms
ever since. The tenderness made careful abdominal study difficult, but
lessened enough after a few days in bed to permit the perception of a
displacement of the right kidney, whose lower edge could be felt on a
level with the umbilicus and two inches to the right of it. No change of
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