Vol. 60, 1909 - University of North Carolina at Chapel Hill

150 THE CHARLOTTE MEDICAL JODRNAL. |
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of a few hours if the sutures have not been Perinephric Abscess-Report of Two
tied too tightly; of thirst, for which cool
Cases.
water should be given frequently in small By T. E. W. Brown, M. D., Asheville, N. C.
quantities; of backache, which may be made Mi'. President and Members of the Society:
more bearable by turning the patient from The subject of my paper is "Perinephric
side to side, rubbing the back with alcohol Abscess." I desire to briefly refer to the
and by the proper adjustment of pillows, anatomy of the kidneys, then review a few
Six or eight hours after an ordinary abdo- of tl,e causes of perinephric abscess and to
minal operation the patient should be fairly
briefly run over the symptoms and course
comfortable and long continued expressions of ^j^ig disease.
of pain should cause us to make sure that ^he anatomical relations of the two kideverythiiig
is as it should be. A too tight
1,^^^ ^re very numerous and interesting, and
or uncomfortable dressing is sufficient to unless they are borne in mind by the phykeep
a patient awake all night. I think it gidan he will be at a loss to explain many
is advisable not to give the patient morphia symptoms, and will be slow in arriving at a
when they are conscious unless we are con- diagnosis, with consequent delay in providvinced
that they are in actual pain. I do not ing proper treatment.
believe in using the catheter until the blad- Ea^h kidney rests on the lower part of
der IS actually distended and causing pam. ^^^ diaphragm, Ouadratus Lumborum and i
At the end of twenty-four hours food is pgoas Magnus mliscles, with anterior laygiven
in liquid form; buttermilk or thm ers of lumbar fascia intervening. The last
broths, and the feedings are increased in dorsal ilio-inguinal and ilio-hypogastric
frequency and amount until the third day nerves pass outward behind each kidney.
when the patient receives solid food entirely. The colon is in relation anteriorly with both
If the bowels have been thoroughly emptied kidneys. The right has the descending!
duodenum along its inner margin anteriorl>|^ (
before operation, about the third day is soon
, r ^, ^ J ^, while the left is m partial contact with I
enough for them to move and they are en-
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