Kidney (organ)

“ The kidney is enclosed in a rigid metal box, the arrangement being such that while the organ can freely expand or contract, and while the changes in volume are recorded by a lever writing with a light glass pen upon the kymograph paper, no obstruction is offered to the entrance and exit of blood by the renal vessels nor to the outflow of urine by the ureter. ”

“ For this reason, should the kidneys of a man be once attacked by disease, the malady is not easily expelled. For it is as though many kidneys were diseased and not merely one; which naturally enhances the difficulties of a cure.
The duct which runs to the kidney from the great vessel does not terminate in the central cavity, but is expended on the substance of the organ, so that there is no blood in the cavity, nor is any coagulum found there after death. A pair of stout ducts, void of blood, run, one from the cavity of each kidney, to the bladder ”

“ When urine contains a larger amount of chemical constituents than it can conveniently hold in solution, a certain quantity crystallizes out, and may be deposited in the kidney or in the bladder. If the crystals run together in the kidney the resulting concretion may either remain in that organ or may find its way into the bladder, where it may remain to form the nucleus of a larger vesical calculus, or, especially in the case of females, it may, while still small, escape from the bladder during micturition. ”

“ The lymphnodes may be opened by longitudinal or transverse incisions.
The left adrenal and kidney are now examined. If the pancreas and stomach have not been removed from the body they are turned over toward the thoracic cavity, so as to expose completely the left adrenal. The movability of the kidney is then tested. [Pg 146] Beginning above the adrenal an incision is made through the peritoneum and underlying tissue, curving outward around the kidney and downward to its lower pole, taking care not to bring the incision too far around the lower pole of the organ for fear of cutting the ureter. ”

“ When the overgrowth of fibrous tissue is considerable, the surface of the organ becomes uneven, and it is for this reason that the term granular kidney has been applied to the condition. In acute Bright’s disease the kidney is increased in size and engorged with blood, the changes described above being in active progress. ”

“ Urinary Organs.—The kidneys in the Mammalia have a compact form, which contrasts with the somewhat diffuse and vaguely-outlined kidneys of the Sauropsida. In mammals the organ is as a rule of that peculiar shape which is called "kidney-shaped"; a depression termed the hilum, which receives the ducts of the glands, indenting the border of an otherwise oval-shaped gland. In some few mammals the kidney is broken up {69}into lobules ”

“ When the kidneys are not working the skin carries off much urea. In fact, a close relationship exists between the kidneys and the skin in the matter of excretion. Thus, with increased perspiration in warm weather comes decreased urine, while in cold weather the blood is sent in and the urine increased in amount.
To incite action of the kidneys drugs known as diuretics may be used. These act in two ways, by stimulating the kidney cells directly and by acting on the general circulation or nervous system. Any emotional or nervous excitement increases the flow of urine. ”

“ It is exceptional for the large branches of the renal artery to be blocked, so that the symptoms produced in the ordinary cases are only the temporary appearance of blood or albumen in the urine. Blocking of the main renal vessels as a result of disease of the walls of the vessels may lead to disorganization of the kidneys. Blocking of the veins, leading to extreme congestion of the kidney, also occurs. ”

“ Fatal terminations, however, do now and again occur, sometimes as a result of injury to the bladder-wall setting up inflammation, which extends to the kidneys, sometimes from suppression of urine. Those cases in which there has been a fatal result most frequently have been complicated with old-standing kidney disease. ”

“ The tubules become blocked by the epithelium, and distended with the pent-up urine; this is one cause of the increase in size that the kidneys undergo in certain forms of Bright’s disease. The lesions in the tubules and in the glomeruli are not generally uniform. The interstitial tissue is always affected, and exudation, proliferation and formation of fibrous tissue occur. In the granular and contracted kidney the lesion in the interstitial tissue reaches a high degree of development, little renal secreting tissue being left. ”

“ For no doubt the diameter of the renal blood-vessels is augmented by their engorgement, and consequently they exert a deleterious pressure on the intervascular tissues, which will interfere with their proper nourishment. While, further, this engorgement of the renal vessels will render the kidneys more liable to the injurious effects of chills; and chills are, as is well known, the most fruitful cause of kidney disease. ”

“ By a bath with soap the pores of the skin are better opened, as the dirt that clogs them is removed, and thus the poisonous products can be given off through the skin more easily, and the skin thereby justifies its name as chief assistant to the kidneys. It is, in fact, our second kidney. When the skin comes into greater activity through the action of the sudorific glands, a part of the solids in the urine and many harmful matters, which otherwise would make their way through the kidneys, are eliminated through the skin instead, in which manner the powers of the kidneys are economized. ”

“ The kidney may be ulcerated, and contain grubs, as well as the liver, it being likewise a gland, but much smaller than the liver. You can injure the kidneys by food, as all water or liquids go immediately to the kidneys; sweet spices and all acids should be avoided, as they coat the kidneys, and cause the gravel; the ureter, or pipe which takes the water to the bladder, finally gets filled and obstructed, so the water cannot pass thence. ”

“ The kidney in the foetus is lobulated, but the intervals between the lobes become smoothed out in later years of childhood. Each gland is invested the renal artery from the aorta passes. Here also the renal vein escapes and joins the vena cava inferior. The ureter or metanephric duct, always behind and below the blood vessels, emerges here and passes downward to the bladder. When the kidney is longitudinally divided from hilum to outer edge, the cut surface is seen to consist of two parts-an outer layer, the cortex, and an inner part, the medulla (fig. 1) . ”

“ The soundness of the other kidney, however, may be considered highly probable if in spite of demonstrated extensive disease of one kidney a sufficient quantity of urine with a normal amount of urea and salts continues to be formed. ”

“ An enhancement of the pressure of the blood flowing through the kidney had no influence on the quantity of the secretion passing away. An increased rate of movement on the part of the blood, on the other hand, increased in equal degree the quantity of urine. On a solution of common salt or of mere serum sanguinis being poured through the kidney, no secretion followed. ”

“ The kidneys are two important organs in the abdomen, one on each side of the spine. They are of a reddish-brown color, and are enveloped by a transparent capsule made up of a fold of the peritoneum. Embedded in fat, the kidneys lie between the upper lumbar vertebræ, and the crest of the hip bone. The liver is above the right kidney, and the spleen above the left, while both lie close against the rear wall of the abdomen, with the intestines in front of them. ”

“ Special organs in the abdomen sometimes require special methods of examination. It is very often necessary for the gynecologist to examine the kidneys, because many women have movable or floating kidneys, and the 21 nervous, gastric, and abdominal symptoms may be due to this condition. The presence of a floating kidney may often be determined by inspection; the presence of a movable kidney, however, must be determined by palpation. ”

“ As a matter of fact and experience, those who drink innocuous and unstimulating fluids freely do not suffer from kidney trouble, but are almost uniformly healthy—at least, so far as the excreting functions are concerned. It is a popular fallacy that the kidneys may and ought to be relieved by the determination of fluid to the surface of the body and perspiration. ”

“ Symptoms of atrophy of the kidney are necessarily those of suppression of urine, with, in certain cases, the passage of casts of the uriniferous tubes and of crystals of salts. There are, however, no absolutely pathognomonic symptoms. When the kidney can be reached through the flaccid walls of a comparatively empty abdomen, or through the rectum, its hard, shrunken condition may assist in diagnosis.
Treatment is not successful in advanced cases. Prevention is to be sought by obviating or treating the conditions on which the atrophy depends. Nephritis must be treated on general principles. ”

“ The kidney and its pelvis form a more or less irregular rounded pouch, with the tense cylindrical tube of the ureter attached to it below. The kidney itself becomes in various degrees atrophied. In some cases it retains nearly all its secreting structure, and is merely spread out upon the surface of the sac; in others, while the pelvis is but little dilated, the true kidney substance atrophies almost completely, and becomes a mere shell enclosing a cavity continuous with the pelvis and broken up by fibrous septa into subordinate cavities representing the original calices. ”

“ It provides points of value in diagnosis, prognosis, and treatment, being especially useful in nephritis, diabetes, acidosis, comatose conditions, gout, and in questions of renal function and treatment, especially dietetic. Urine findings are always dependent upon kidney function, and, by blood chemistry, we can pass behind this barrier. ”

“ In the kidneys are a large number of bits of living matter (kidney cells) , which have the power of seizing hold of the urea as the blood is flowing over them, and after thus taking it out of the blood they deposit it in a series of tubes which lead to the bladder and hence to the exterior. The bringing of this ash to the kidney cell is a mechanical matter, based simply upon the flow of the blood. The seizing of the urea by the kidney cell is a vital phenomenon which we must waive for the moment. ”

“ The kidney, until thirty years ago, was deemed almost beyond our reach, but now entire volumes have been written on the surgery of the kidney, and it is, one might say, a frequent occurrence to see the kidney exposed, sewed fast if it is loose, opened to remove a stone in its interior, drained if there be an abscess, or, if it be hopelessly diseased, it is removed in its entirety. ”

“ Kidneys undergoing this process of degeneration [p. 49] often furnish up to a short time before death a normal, or even more than normal, amount of urine, and one is often astonished to find how little disturbance of elimination has been caused in cases where the true kidney-structure seems to the naked eye to have been almost entirely destroyed.
The DIAGNOSIS of a calculus remaining in the pelvis of the kidney depends chiefly on the determination of hæmaturia and pyelitis for which no other cause can be found, and upon the presence of pain in one loin. ”

“ The most rational hygiene of the kidneys for the prevention of kidney diseases consists in the avoidance of all those causes which are injurious to the kidneys, and which we have mentioned in the previous chapter. A great part of the poisonous products that are eliminated by the kidneys are introduced with the food and beverages, and it is important for us to bear in mind the fact that what we eat or drink must pass through our kidneys, and that the structure of these organs is delicate ”

“ The kidneys begin to suffer and give out; the supra-renal capsules change their fibre, and no longer act as storehouses for the kidney-life placed there daily by the watchful soul. The bladder goes next, then the testes, prostate, ovaries, or uterus follow; and before you know it, the man or woman is a splendid wreck. ”

“ The immediate causes of inflammatory action in this viscus are blows and contusions in the lumbar region; hard work long continued, and the imprudent use of stimulating substances employed as aphrodisiacs; the presence of calculi in the kidney, and the arrest of the urine in the bladder. The whole of the kidney may be affected with anæmia or defect of blood, or this may be confined to the cortical substance, or even to the tubular. The kidneys are occasionally much larger than usual, without any other change of structure ”

“ The arterioles of the kidney being, like all other arterioles in the body, under the control of the nervous system through the vaso-motor nerves, it is easy to see how the various affections of this controlling element may act upon the secretion of urine; neither is it possible to deny (although by far the most important factor in the rapidity of the urinary secretion has been shown to be the blood-pressure) that the nervous system may have a direct effect upon the secreting renal parenchyma. ”

“ His Kidneys cover'd with fat, and pretty sound; only in the anterior surface of them there were found some aqueous or serous (as 'twere) abscesses, whereof one was near the bigness of a Hen-egge, with a lowish water in it, having made a roundish cavity, impressed in that kidney: whence some thought it came, that a little before his death a suppression of Vrine had befallen him; though others were of opinion, that his Vrin was suppressed upon the regurgitation of all the Serosity into the Lungs. ”