The disease may result from twisting or bending of the ureter in floating kidney ; or it may follow an obstruction of the ureter by a stone, or com pression of the ureter by a tumour. It may be due to an antecedent inflammation of the pelvis of the kidney, to displacement of the \ vonth, or to narrowing of the urethra. The chief symptoms consist in sudden vomiting, headache, sensations of pressure and pain in the region bf the affected kidney, diminution in the amount of urine voided, and the formation of a swelling in the side of the abdomen. Pressure or change of position may lead to a sudden decrease in the size of this swelling, accompanied with profuse discharge of urine. Treatment can be carried out only after the cause of the affection has been accurately determined. Surgical treatment offers the only cure.
Floating Kidneys.—The kidneys, like all other abdominal organs, are fastened in their position in the abdomen. If a kidney break loose from its anchorage, it tends to sink ; it changes its position constantly, according to the position of the patient, arid thus gives rise to many of disease. Floating kidney is seen very frequently in women between the ages of twenty-five and forty-five, mostly affecting the right side. It is caused by the disappearance of the fat which surrounds the kidney and holds it in place. This condition arises in connection with all wasting diseases, with rapid emaciation, or from relaxation of the abdominal musculature. The last-named cause may result from repeated childbirths, from getting up too soon after confinement, from the tension exerted by the intestines upon the suspensory ligaments of the kidney, or from disease or change of position of the female sexual organs. Other frequent causes are tight-lacing, severe physical labour, and the lifting of heavy objects.
In many cases floating kidney gives rise to only slight symptoms, or to no symptoms at all ; in others, very unpleasant conditions ensue. As a rule, the patient complains of nervousness, general uneasiness, frequent malaise, heaviness, and of pressure and slight pain in the abdomen. Walking and severe physical exercise (riding, dancing, etc.) may greatly aggravate the condition. Among other complaints which frequently accompany the affection may be mentioned attacks of nervous pains in the lumbar region or between the ribs, severe headache, disturbances of the stomach and intestine, and especially constipation. A sudden change of position with torsion of the body will cause severe colicky pains in the stomach, accom panied by chills, vomiting, sensations of fear, retention of urine, and, in rare cases, by dropsy of the kidney.
Floating kidney is not a dangerous affection. The annoying symptoms generally subside in a very short time if the kidney can be replaced in its normal position and kept there. When symptoms of incarceration are present, the replacing of the kidney must be undertaken only by a physician. Elastic bandages, corsets, etc., for holding the kidney in position, should always be selected by a specialist, and not by a belt-maker. Very good results are obtained from a course of forced feeding, massage of the kidney, and methodical water-treatment. In severe cases it may be necessary to perform an operation by which the kidney is securely sutured into its proper position.
Inflammation of the Pelvis of the Kidney.—Acnte and insidious inflamma tion of the kidney-pelvis may arise in consequence of the entrance of patho genic germs, which may reach the kidney through the ureter in gonorrhoea or in inflammation of the bladder, or through the introduction of an unclean catheter. A bacterial infection of the kidney-pelvis may be brought about also by means of the blood, if the bacteria (as in typhus, scarlet fever, puerperal fever, or blood-poisoning) reach the kidney through inflammation of the lungs. Other causative factors are suppurative inflammation of the kidneys, and the irritation exercised upon the kidney-pelvis by poisons or by granules or stones of the kidney.
The attack most frequently begins with a gradually increasing pain on one side, in the vicinity of the kidney. The urine is cloudy ; and, upon standing for some time, it forms, without becoming clear itself, a yellowish white deposit, which frequently comprises one-third of the total amount of urine. This deposit consists of mucus, pus, and blood. When pus is present in the pelvis of the kidney, there is high fever, with chills, nausea, and vomiting. In most cases inflammation of the kidney-pelvis is accompanied by some other affection of the kidney. Except in light cases, the course of the disease is apt to be prolonged, especially \\•ien the kidney proper is involved. Nevertheless, the issue is usually favourable ; and, except where a considerable formation of IS takes place, the disease does not endanger life. General measures that are helpful in the treatment of this disease include rest in bed, simple food (preferably a milk diet), copious drinks of mineral waters, and lukewarm baths. The special treatment for each individual case must always be left to the physician. An operation is usually necessary.