American practitioner and news . well and free from pain since operation. Therewas no obstruction to either ureter; the left kidney was smalland showed clearly the infantile Lobulations. Whether thereferred pain was due to the diseased cervix, or whether itresulted Erom the vanicose condition of the vein, I am unableto say. The point to he emphasized is, it stimulated a Left-sided renal colic, and yet was not due to disease of either thekidney or ureter. Reference to the diagram shows that the uterus, like theprostate, has a double innervation; one, and apparently theprincipal one. in the firs
American practitioner and news . well and free from pain since operation. Therewas no obstruction to either ureter; the left kidney was smalland showed clearly the infantile Lobulations. Whether thereferred pain was due to the diseased cervix, or whether itresulted Erom the vanicose condition of the vein, I am unableto say. The point to he emphasized is, it stimulated a Left-sided renal colic, and yet was not due to disease of either thekidney or ureter. Reference to the diagram shows that the uterus, like theprostate, has a double innervation; one, and apparently theprincipal one. in the first, second, third and fourth sacral, andfifth Lumbar segments, and the other in the tenth, eleventh andtwelfth dorsal, and the first lumbar. W8 The American Practitioner and News. This figure is diagrammatic only. The shaded areas represent the segments from which the renalnerves arise. Sympathetic ganglia are represented as attached to each pairof spinal nerves which is not strictly correct, but is made use of toavoid L.— Liver G. B.—Gall Bladder I.—Intestines P.—Prostate 0. & E.—Ovary and Epididymis U— Uterus B— Bladder Zimmerman: Pain as a Symptom of Renal Disease hOlJ The ovary and testicle form central connections with thetenth dorsal, and possibly also with other of Ih lower dorsalsegments, since painful affections of these organs produce painsreferred to the renal field. Attention has already been called to the similarity of renalpain to that of gallbladder disease. Reference to the diagramwill show that the gall-bladder receives a pari of its nervesupply from the tenth dorsal segment, which also gives fibresto the kidney. An enlarged gallbladder, dispaced well to theright, may be mistaken for a displaced and enlarged ipain may be very similar, and differential diagsosrisis, at times, extremely difficult. An acute appendicitis is notusually mistaken if the appendix lies in the usual position. If-however, it have a retro-eecal attachmen
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