. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. on due to supernumerary blood vessels is a ratherrare condition. Finally, the high insertion of the ureter into the pelvis ofthe kidney or its oblique insertion has been thought by someto be a common obstruction. This seemingly high insertion is, we believe, moreoften a result of the downward movements of the kidney and of the gradualdevelopment of the distention. It is met with in all cases of large hydro-nephrosis. Trauma plays an undeniable role; a number of cases are on record where hydronephro
. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. on due to supernumerary blood vessels is a ratherrare condition. Finally, the high insertion of the ureter into the pelvis ofthe kidney or its oblique insertion has been thought by someto be a common obstruction. This seemingly high insertion is, we believe, moreoften a result of the downward movements of the kidney and of the gradualdevelopment of the distention. It is met with in all cases of large hydro-nephrosis. Trauma plays an undeniable role; a number of cases are on record where hydronephroses have fol-lowed injury to the kid-ney. Most of such aredue to pressure from ac-cumulations of surround-ing blood upon the ureterand uretero-pelvic junc-tion. As a result of injurythere forms a large hema-toma in the perirenal tis-sue in many cases. Somehydronephroses result fromthe formation of bloodclots in the kidney andtheir passage through theureter. These traumatichydronephroses may ariseinunediately at the time ofinjury, or the injury maylead to changes whichcause a gradual develop-. FlG. 255. — Moderate Hydronephrosis Due toPressure on the Ureter by Cyst in SinusRenalis. The cyst in this case was thin-walled andfilled with clear fluid, and although in most intimatecontact witii kidney, as shown in drawing to theright, it communicated with neither the parenchymanor the pelvis. (Autopsy, No. 68, Bay View, Oct. 3,1908; specimen loaned by Dr. Milton C. Winternitz.) ment of the condition. Compressions of the urethra or obstructions of the flow through the urethra always lead to bilateral hydronephrosis. It is common in cases of prostatic hypertrophy. Probably the commonest cause of bilateral hydronephrosis in the female is cancer of the cervix uteri. Almost
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