. American journal of obstetrics and gynecology. umerous clumps of wliite blood cells. P. S. p. Output.—First 2 hours 25 per cent; third hour 25 per cent. Urine examination on admission.—Faint trace of albumin, sugar per cent,occasional red blood cells, acetone and diacetic acid present. Blood chemistry.—Urea nitrogen , incoagulable nitrogen , sugar lilood pressure.—150/90. Pyelograms were made. (Fig. 4.) Case 2-—S. M., aged fifty-eight, had been married 32 years, four children, oldest 702 THE AMERICAN JOURNAL OP OBSTETRICS AND GYNECOLOGY 28 years, youngest 19 years. Menopau
. American journal of obstetrics and gynecology. umerous clumps of wliite blood cells. P. S. p. Output.—First 2 hours 25 per cent; third hour 25 per cent. Urine examination on admission.—Faint trace of albumin, sugar per cent,occasional red blood cells, acetone and diacetic acid present. Blood chemistry.—Urea nitrogen , incoagulable nitrogen , sugar lilood pressure.—150/90. Pyelograms were made. (Fig. 4.) Case 2-—S. M., aged fifty-eight, had been married 32 years, four children, oldest 702 THE AMERICAN JOURNAL OP OBSTETRICS AND GYNECOLOGY 28 years, youngest 19 years. Menopause 9 years ago; prolapse for the past 8 years;patient has worn a ring pessaiy. Examination—Small rectocele, lacerated cervix, slightly eroded; huge cystocelethe whole bladder being prolapsed. (Fig. 5.) Cystoscopic examination—Bladder completely prolapsed through ureter found after restitution of bladder. A catheter was easily introduced,and passed up to the kidney pelvis. Owing to numerous folds and distortions the. Fig. 4.—Pyelogram (sodiuiri broniiile) in Case 1. showing bilateral hydrouret«r andhydronephrosis. The right ureter Is distended witli the opaque solution. The leftrenal pelvis is dilated; left ureter is empty of opaque solution. left ureter was more difficult to identify. But with the removal of pessary andvaginal manipulation restoring the normal relations of the trigone, the left ureterwas located and a catheter passed up for a distance of 5 cm. A test tube filledin 2V(> to 3 minutes on the right side. On the left side the test tube filled con-siderably slower. Ureter orifices fairly small. Good concentration of indigo-car-mine on left side in 10 minutes; faintly on right. Introduced C of sterile waterinto loft ureter. Patient complained of severe pain on left side. Fifteen ofwater was introduced on right side before patient complained of pain. BRETTAUER AND RCniX : HYDROURETER AXD HYDRONEPHROSIS 703 Diagnosis—Hydro
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