. The New England medical gazette : a monthly journal of Homoeopathic medicine, surgery, and the collateral sciences. n the urine of the left kidney withinfifteen minutes,imaintained for one hour; in this time the right kid-ney failed to excrete any glucose at all. We therefore made a diag-nosis of obstruction of the right ureter, confirmed by the X-Raywhich showed calculi, probable degeneration of the right kidney,and a left kidney of good capacity as decided by urinanalysis aswell as by the phloridzin test. Operation revealed precisely thatcondition of affairs, a large pyo-nephrosis, kidney
. The New England medical gazette : a monthly journal of Homoeopathic medicine, surgery, and the collateral sciences. n the urine of the left kidney withinfifteen minutes,imaintained for one hour; in this time the right kid-ney failed to excrete any glucose at all. We therefore made a diag-nosis of obstruction of the right ureter, confirmed by the X-Raywhich showed calculi, probable degeneration of the right kidney,and a left kidney of good capacity as decided by urinanalysis aswell as by the phloridzin test. Operation revealed precisely thatcondition of affairs, a large pyo-nephrosis, kidney riddled withstones with little secreting structure left and an ureter filled withmultiple soft stones right down close to its vesical insertion. There is another condition in which this instrument offers ad-vantages to the surgeon, namely, vesico-vaginal fistula. An unusualcase of this type was admitted to the service of Dr. Tuttle, to whomI am indebted for the privilege of reporting it, at the Flower Hos-pital this spring and it presented so many interesting features that 1914 The New England Medical Gazette 65. Fig. 5. Skiagram of pelvis showing a very small pelvic basii: with lumbar two ureters are shown by means of Bismuth catheters ; the fistula is indicated bythe fine wire-line; the vesical opening of the fistula being situated at the loop of thesetwo fine lines, one arm of the loop passing from the urethra to the fistula, the otherfrom the vesical end of the fistula through it to appear in the vaguia. a report of it may be of value. The patient was a young coloredwoman who beside a pelvic deformity had a scoliosis and had sometime before been delivered by craniotomy following several unsuc-cessful efforts with high forceps outside of the hospital. The cysto-scope showed a bladder practically normal without any markedcystitis, but the base of the bladder was distorted; the mouth of thefistula could be plainly seen about J^ of an inch posterior and to therigh
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