DOI: 10.7925/drs1.ucdlib_280088
title: Malignant disease of the kidney

description: Watercolour medical illustration depicting malignant disease of the kidney. It has the alternative reference numbers 1697, 358 and P6A on the front. The artist's name is in the bottom right corner 'J. Connolly Del.t'. The Richmond Hospital Museum reference is A.b.5. The entry for this in P263/1 pg. 6 reads 'Abscess surrounding the urethra, cystitis etc. Dennis Donoghue aet 78'. The typed note on the back begins 'Malignant disease of the kidney'.
description: Scope and content: The full typed note on the back reads 'Malignant disease of the kidney. Dr Hutton presented a specimen of cerebriform disease of the left kidney, and gave the following details of the case. The subject of the disease was a man aged sixty-three years, who was admitted into Richmond Hospital upon the 26th April 1848. His general aspect, on admission, was that of a person labouring under malignant disease. He was much emaciated, his complexion was sallow, and his countenance wore an expression of anxiety; and he complained of pain, which he referred to the region of the spleen, where a firm and solid tumour was detected; it was accompanied with dulness [sic] of sound on percussion, corresponding to the three last false ribs. The tumour, which could be felt while the man was lying on his back, was solid and uneven upon its surface, and was found to pass upwards beneath the cartilages of the false ribs. It projected, however, considerably in front, and, but for its extreme hardness and nodulated character, would have led to the impression that it was an example of the enlarged spleen occasionally found in patients who had been attacked with intermittent fever. There was no derangement of the urinary functions in this patient. Although aware that the case was quite hopeless, Dr Hutton nevertheless took the man into hospital, in order that he might watch the progress of the disease. With the exception of the pain in the region of the spleen, which was not so severe as to interfere with the examination of the part, the symptoms were very obscure. There was no loss of appetite or of strength; neither was there diarrhoea, nor were any of the symptoms of hectic fever well developed. Still, however, he became slowly but progressively emaciated, and at length died on the 11th of October last, about six months from the time of his admission. Post mortem examination. Upon opening the abdomen the liver was found to contain several scirrhous tubercles. The left kidney was greatly enlarged; it occupied the region of the spleen. On making a section of the organ, its entire substance was found to be converted into one cerebriform mass, through which a number of large cells were scattered, one of which , in the upper portion of the kidney, was occupied by an immense calculus, which had been felt during the patient's life. Its nucleus was composed of oxalate of lime, around which lithic acid was deposited. In another of these cells a peculiar appearance, which he had never seen in any other case was observed. This was a kind of soft fibrous substance, which evidently had no organic connexion with the containing cyst. The arrangement of its fibres was peculiar, being in one situation laminated, and in another running vertically with respect to the wall of the cyst in which it was found. Some of the fluid portion of the disease was examined under the microscope, and was found to present the peculiar nucleated cells said to be indicative of malignant disease. The other kidney was healthy'. The handwritten not in the bottom left corner reads ' Encephaloid disease of the kidney'.
description: Numbering/sequence: Original reference number: 1697.