This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1914 edition. Excerpt: ...the fistula and obtaining a radiograph the course of the track can be followed, and a cavity in the thorax or elsewhere may be demonstrated. There is frequently a peri-renal cavity which is not necessarily connected with disease in the kidney. (2) In a urinary fistula is the ureter patent? This information is obtained by catheterisation of the ureter. (3) What is the functional power of the fistulous kidney P The urine from both kidneys is withdrawn by catheter, examined and compared, and the discharge from the fistula is also examined. The phloridzin and methylene blue tests of the renal function should be used. Treatment.--In non-urinary peri-renal fistulse extensive operations may be required, such as the exploration of the perinephritic tissue, the search for a diseased retro-caecal appendix, or the obliteration of a cavity in the pleura by resection of ribs. When a permanent renal fistula is intentionally produced, the treatment will consist in the provision of an eflicient apparatus to collect the urine discharged and prevent it from soaking the clothes. A modification of Irvings supra-pubic drainage apparatus is the best for this purpose (Fig. 1). It consists of a shallow celluloid cup with rolled-over edge, and a flat detachable bottom which is perforated. A rubber drain opens on the dependent part of the wall and leads to a receptacle. The apparatus is held in position by rubber bands which pass round the body. When a lumbar fistula follows nephrectomy, the cause is usually a septic ligature. The fistula usually penetrates deeply to the renal pedicle. It may be scraped and cleaned out by means of a plug of gauze rolled round sinus forceps. If it persists, the track should be dissected out and pockets opened up. In...