File:The surgical diseases of the genito-urinary organs including syphilis (1889) (14594733538).jpg

Identifier: surgicaldiseases00keye (find matches)
Title: The surgical diseases of the genito-urinary organs including syphilis
Year: 1889 (1880s)
Authors: Keyes, E. L. (Edward Lawrence), 1843-1924
Subjects: Urology Syphilis
Publisher: New York : D. Appleton and Company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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us through-out, tending, as itdoes, to be irregularlyintermittent withoutappreciable cause.Often during theparoxysms it is veryprofuse, perhaps clot-ting in the ureter orbladder, aiid causingconsiderable incon-venience and pain.If distressing feelingshave been present,some alleviation ofthem is apt to fol-low profuse bleeding.When h^ematuria isabundant and parox-ysmal without provo-cation, in the case ofrenal tumor, cancershould be suspected.Vesical irritabilitymay be the only pro-nounced symptom,leading the careless observer to overlook the kidney and to search forthe seat of the disease in the bladder. Among other symptoms there may be ascites, anasarca, and greatdevelopment of the cutaneous abdominal veins, from pressure of thetumor upon the large venous trunks within the abdomen. The sizeof the tumor may cause functional derangements of the stomach andbowels. Vomiting sometimes appears early. The urine presents nocharacteristic diagnostic features. It is idle to place any reliance
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Fig. 104 (Roberts). 350 DISEASES OF THE KIDNEY. Tipon the appearance of so-called cancer-cells in the urine, or upontlie hope of finding a shred of cancer-tissue, since such a shred, start-ing at the kidney, already softened and partly decomposed by iho.ulcerative process which loosened it, would become wholly indistin-guishable asa portion of cancer after traversing the ureter and remain-iucr soaked in urine in the bladder for even a short time. In childrenthe disease is more rapidly fatal than in tiie adult. It rarely lastsover a year. The tumor grows to an immense size, not infrequentlylining the whole abdomen. The patient emaciates rapidly and dies. Fig. 104 is an excellent representation of a child with advancedcancer of the kidney. It is rather too extreme to be typical. Adults with cancerous kidney usually die in two or three years,but many drag out more than double that length of time (Roberts).Cancerous cachexia is more liable to be marked in the adult than inthe child. TJie

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