A practical treatise on urinary and renal diseases : including urinary deposits . a manner as to preventthe free passage of faeces. The kidnej7s, ureters, and renal arterieswere carefully dissected out with a view of ascertaining the mechanicalcause of the impediment to the flow of the urine, which produced themischief. On the left side (Fig. 61), the renal artery was normal in its distri-bution ; but the ureter presented an anomaly. At its origin from thedilated pelvis, the ureter was exceedingly narrowed; its bore was socontracted that only a fine probe could be passed along it. Theentrance
A practical treatise on urinary and renal diseases : including urinary deposits . a manner as to preventthe free passage of faeces. The kidnej7s, ureters, and renal arterieswere carefully dissected out with a view of ascertaining the mechanicalcause of the impediment to the flow of the urine, which produced themischief. On the left side (Fig. 61), the renal artery was normal in its distri-bution ; but the ureter presented an anomaly. At its origin from thedilated pelvis, the ureter was exceedingly narrowed; its bore was socontracted that only a fine probe could be passed along it. Theentrance of the ureter into the pelvis was also oblique, so that a valve-like obstruction was thereby constituted. The action of this latterimpediment was clearly shown when the sacculated mass, after beino-separated from its connections, was held in the hand, and subjected tovarious degrees of pressure. With moderate pressure no urine escapedfrom the cut end of the ureter ; but when the mass was strongly com-pressed, the obliquity of the origin of the ureter was for the time effaced,. Fig. 62. The left kidney cut open (about one-fourth the actual size). ?and urine escaped freely. The same thing doubtless happened duringlife. When the distension of the kidney was moderate, the course of theurine was obstructed; but when the urine accumulated and the dis- 494 HYDRONEPHROSIS. tension became great, the obstruction was at length overcome, and thecontents of the sac escaped. The lower portion of the left ureter wasfree from obstruction, and of the usual dimensions. When this kidneywas laid open, it (with the pelvis) was seen to be converted into one largelobulated sac, filled with urine (see Fig. 62). The renal substance wasreduced to a thin layer, varying from a line to two lines in thickness,which formed the outer boundary of the sac. There were no traces of thepyramids. The infundibula and calices were enormously dilated, andconstituted the sacculations which gave the mass its lobular cha
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