. The diagnosis of diseases of women . the opposite hand. Theimpact is not always discerned,but seldom fails when the kidneyis large or when movable and theabdominal walls thin and relaxed. Little or no pain is experiencedfrom palpating a normal kidneyor new-formation of the a calculus is present or thekidney inflamed there is more orless tenderness. As with the uterusso with the kidney we recognizeby palpation the position, size,mobility, form, and sensitiveness to pressure. We must, therefore,regard palpation as a method of the greatest value. 4. Percussion is of little value in
. The diagnosis of diseases of women . the opposite hand. Theimpact is not always discerned,but seldom fails when the kidneyis large or when movable and theabdominal walls thin and relaxed. Little or no pain is experiencedfrom palpating a normal kidneyor new-formation of the a calculus is present or thekidney inflamed there is more orless tenderness. As with the uterusso with the kidney we recognizeby palpation the position, size,mobility, form, and sensitiveness to pressure. We must, therefore,regard palpation as a method of the greatest value. 4. Percussion is of little value in the physical examination ofthe kidney. Unless the kidney is very greatly distended there willbe a tympanitic note over the kidney anteriorly, which serves todistinguish the right kidney from the liver and the left kidneyfrom the spleen. Posteriorly percussion is of still less value. Be-tween the kidney and the vertebral column there is no area ofresonance. This, however, is of little value in dealing with en-largements of the Vertical section of kidney. (Gray.) 548 DIAGNOSIS OF DISEASES OF THE URINARY SYSTEM 5. Catheterization of the ureters is discussed on page 536. 6. The x-rays were formerly relied upon more than at the presenttime. At times they prove most satisfactory, but in general theyare unreliable in the diagnosis of renal calculi. Not only does ashadow often fail to appear when a stone is present in the kidney,but a shadow has been repeatedly found to indicate the presenceof a stone when an exploratory operation failed to find it. 7. Exploratory incisions are justifiable as a last resort in allenlargements of the kidney and in calculi. The natural rangeof movements varies, but probably does not exceed one and one-half inches. MOVABLE KIDNEY. Under normal conditions the kidney is firmly embedded in fatand is supported by the fat, the overlying peritoneum, and therenal bloodvessels. (See Plate LIX.) A movable kidney may be a congenital lesion, but is almostinv
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