The times dispatch. [volume] (Richmond, Va.) 1903-1914, 1908-05-06

DNs ltVbtIfti ADDICT
OF New York.
Andrew McCosh OF .tew York, and the
statistics conected by him from his
personal practice and other sources
were of great value.
Discussion of the papers was In order
at this point but motion was made
and carried that as Drs. Cabot and
Frazier were absent the two remain
ing papers be read before discussion
was begun. Thereupon DIR. Armstrong.
OF Montreal, was heard on THE dag
nosis and Prognosis OF Tuberculous and
Septic Conditions OF the Kidney" Dr.
Armstrong; paper was carefully pre-
pared and we'll received.
DR.. Brewer. who was next in order
read an excellent thesis on Acute Unit
lateral acknowledgements Infections Of
the Kidney" He divided such cases
into three groups, discussing the opcr-
alton indicatsd in each. the severe type
requiring nephrectomy. the interne-
diary ncphrotomy. with drainage, and
the mlldest form. which required no
operation.
Discussion of Papers.
AT the conclusion of Dr. Brewers
paper, discussion was begun on the
papers of the morning. and large
number of members participated
DR.. McCosh had raised the question
as to whether the stone should be re-
moved by an incision through the pei
Wis or Darenchyma of the kidney. stat
ing that he had originally cut through
the pelvis. but 1t was now his pra ctice
to extract it through the parenchyma
tous portion of the organ In his own
experience in five operations. in which.
tine stone was removed through the
pelvis of the kidney, there was sub
sequent leakage of urine in four,
whereas In six cases In which the stone
was reached through the parenchyma
| there was only one case OF leakage.
| The dangerous complication of renal
hemorrhage was fully discussed and
preventive treatment therefor ex-
| planned.
| DR.. Freeman, of Denver. used the
incision through the parenchyma OF the
kidney, and controlled hemorrhage by
the use of misunderstanding forceps
protected with rubber tubing. He re-
ferred to apparent renal calculi and
the possibility of calcified lymph glands
or phleboliths being mistaken for kid
ney stone. Several X-ray pictures were
exhibited by him
| IL,
symptom or group of symptoms was
pathognomonic Of renal calculus. He
attached great Importance to the X-ray,
but insisted on good plate-one that
would show clearly the outline of the
psoas muscle and the vertebrae He
| cited case in which a calcified ap-
| pendiN epiploica was mistaken for
| stone, and called attention to an i'm
i portant diagnostic point-that the
I! shape OF stone in the ureter was al
| WAYS oblong.
! Dr. Jacobson. of Syracuse n. y, en-
hibited an interesting series of positive
;plates Of specimens operated on.
DR.. Rensohoff did not place too much
/ confidence in the X-ray, but insisted
that thorough clinical diagnosis was
Indispensable
i Importance of Diagnosis.
|. DR.. Richardson discussed the impor.
j; lance Of diagnosis with particular re-
!. terence to history, and thought hem
| orrhase his worst difficulty, He adj
ded that surgeons should spend more
, time on diagnosis and the discussion OF
i COMMUNICATIONS When told that his
/ five minutes were up, lie caused mucl
amusement by stating that time passc,
more rapidly when he was speaking
than when he was listening.
DR.. Criles talked for five minutes or
the advisablity of resuturing divided
!, nerves and the danger of hemorrhnge
{ relating an interesting case In which
hemorrhage had occurred, necessi
tating second operation. TRANSMISSION
: of blood was performed during the en-
tire operation. Recovery cnsued.
DR.. Finney, of Baltimore. seconde{
: Dr. Richardson's remarks, and did no
think diagnosis should be made on an,
y one sign Or, Shepherd. OF Montreal
: Canada. considered hemorrhage ser
'ous trouble and said that not enough
= attention had been given It by til,
9, papers, At this iuncture DIR. oliver en-
G hib!ted a kidney stone slightly snlallc
u than pr. Rarrow's with the statemen
that he knew Kentucky would go hin
y one better. The peculiarity OF TIL
: specimen was that 1t was compose
u entirely Of oXalate of calcium.
G Many others took part in the discus
Z sion Including Drs. Nnacrcac, Elio,
n Meyer Gibson and Gerster after whic
Or. Bevan resumed his remarks. Til
hotel orchestra then struck mp n livel
air and a recess until 2:30 o'clock wa
. taken,
t. Afternoon Session,
Y The afternoon session was opened b
y Or. BeNan, who simply reviewed hi
~ paper, laying particular emphasis o
~ what he regarded the important point
Y as already outlined, Motion was mad
s and carried 10 the effect that Dr, Muir
Isl phys paper on "Retention cysts of tn
$. Renal PelTis,n the next in order, h
= read by title
d DIR. a. II, Rristow, Of Hroollgn sub
limited detailed report of "a Gas