. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. 04, xxii, 1,:](U)emphasizes their im-portance and statesthat cutting the ves-sels would often curethe condition. Eke-horn (Arcli. f. ,, 1907, Ixxxii,955) has clearlydrawn attention tothis matter and em-phasizes its impor-tant practical bear-ing. Furthermore,it has been particu-larly illuminated inthis country by ]\Iayo and anumber of cases re-ported by him a r emost convincing. Bear in mind inthis connection thatit is easy to confusecause a n d effect;that in many of theold and la
. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. 04, xxii, 1,:](U)emphasizes their im-portance and statesthat cutting the ves-sels would often curethe condition. Eke-horn (Arcli. f. ,, 1907, Ixxxii,955) has clearlydrawn attention tothis matter and em-phasizes its impor-tant practical bear-ing. Furthermore,it has been particu-larly illuminated inthis country by ]\Iayo and anumber of cases re-ported by him a r emost convincing. Bear in mind inthis connection thatit is easy to confusecause a n d effect;that in many of theold and large hydro-nephroses the vessels are drawn out of place and seem to obstruct the ureter, whc^n in reality theyhave no such bad effect, but have been drawn into their abnormal position bythe distending pelvis. Certainly in most cases it is not merely the condition ofsupernmnerary blood vessels, but the fact that tlu^ kidney is abnormally mov-able, which determines the development of the distention. In Figiires 25] and254 is shown an excellent example of how descensus of the kidney has led to a. Fig. 254.—Same KroxEY as Shown in Last Figure. Notehow, in si^ite of dilatation of pelvis and of calices, the necksof calices have remained comparatively small and con-tracted. 526 HYDRONEPHEOSIS kinking of the ureter by the accessory vessels, which in this case pass beforethe ureter near its junction to the pelvis. With a differently shaped kidney itis quite possible for abnormal posterior vessels to lead to like results, althoughthis is rare. It is our personal inij)ression from observation of a number ofhydronephroses that obstruction 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 dist
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