IX.
ACHING KIDNEY—PYONEPHROSIS—STRICTURE OF URETHRA.
The first subject of this lecture is Aching Kidney. I shall read to you no individual case of this disease, because, in the class of patients that come to St. Bartholomew's, it is not considered grievous enough to secure a bed in the hospital. Among the better classes, where diseases are often unjustly appraised, it is often regarded as of the greatest importance and interest. TV r e have had many cases in "Martha" of aching kidney, but in them this affection has been merely an epiphenomenon, or a part of other diseased conditions.
This disease is sometimes, both in men and women, very easily recognised. There are achings in cases of what is called floating kidney. The patient can put her hand upon the lump, and say, "Here is the pain," and there is no difficulty in recognising the disease. But there are some cases in which the disease is difficult to identify. In pregnancy, for instance, right or left hypochondriac pain is very frequent. In many cases I have been able to be quite sure, from the history before and after pregnancy, that the disease was not to be classified in the vague way that is implied in giving it the name of hypochondriac pain, but that it was really aching kidney. In pregnancy you have opposite conditions to those in floating kidney in ordinary circumstances, for if pregnancy is advanced, you cannot get at the kidney to feel it and identify its position.
