FLOATING KIDNEY The kidney under physiological conditions is slightly movable, so that the distinetion between pathological and physiological mobility may not be perfectly distinct. The anomaly may without doubt be congenital, as is proven by the observations of Chanmey, Hoillmoser, and PhiHipps. (The last was a baby six weeks old, whose kidney was extremely movable.) If congenital, the anomaly is tbe result of ana tomical peculiarities of the mesentery and of the renal blood vessels, and according to Orth, anatomical peculiarities of the mesentery pre dispose to the development of the acquired form.
Symptoms.—While congenital dislocated kidney is usually situated on the left side, unilateral floating kidney Is generally on the right. The reports of Kuttner, Coniby, Hollederer, KnOpfelmacher, Blum, and others have shown that floating kidney is nothing like itS rare in infancy as was once supposed. Girls are more frequently affected than boys. It may exist without any symptoms, its discovery being made accidentally in the course of an examination for some other condition. There may be a feeling of pressure and heaviness, dyspeptic conditions, attacks of pain, appearing especially where the abdomen is subjected to jar, and radiating into the extremities. However, these symptoms
are not pathognomonie of floating kidney alone, since the latter is itself frequently but one phase of a general splanchnoptosis. Those violent paroxysms of pain which are clue to torsion of a floating kidney, and which may lead to collapse and fainting, seem to be rare in infancy.
The diagnosis of floating kidney is made by palpation. It can be certainly established only when we can detect a movable, smooth, oval or kidney-shaped tumor, easily replaced into its normal position. The differential diagnosis requires ruling out of the same conditions as in dystopia of the kidney.
The. treatment is local and general. After the kidney has been replaced it must be retained in its normal position by means of suitable bandages. In the more severe cases, nephropexy may be required. Regulation of the intestinal action, and in the case of amemic, weak individuals, the improvement of the general health by appropriate diet and the use of iron tonics will be of service.