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Updated: June 27, 2025


The hollow or concave side of the kidneys is turned inwards, and the deep fissure of this side, known as the hilus, widens out to form the pelvis. Through the hilus the renal artery passes into each kidney, and from each hilus passes outwards the renal vein, a branch of the inferior vena cava.

The most frequent cause of such a reflex is abdominal pain, perhaps due to some serious condition in the stomach, to gastralgia, to an intestinal twist, to intussusception or other obstruction, or to hepatic or renal colic. A severe nerve injury anywhere may cause such a heart reflex. Hence serious nerve pain must always be stopped almost immediately, else cardiac and vasomotor shock will occur.

A good illustration of subcutaneous rupture of the arteries of the head is afforded by the tearing of the middle meningeal artery caused by the application of blunt violence to the skull; and of the arteries of the trunk caused by the tearing of the renal artery in rupture of the kidney.

As a result, the secretion of the kidneys is scanty, but it contains an unusual percentage of solids. When the atmosphere is cold, the reverse is true. The cutaneous vessels contract, the blood is driven to the deeper organs with increased pressure, and there is a less amount of sweat, but an increased renal secretion, containing a smaller proportion of solids.

That of an elderly patient with marked vascular disease, often renal involvement, and distinctly impaired nutrition. There may be renal retinitis or retinal hemorrhages. The case may easily become one of hemorrhagic glaucoma. It may run a very chronic course.

Two cases which were transferred from the "pleasant" to the "unpleasant" group on account of constraint feelings, were also renal cases, VII and IX. The only exception to the universality of renal lesions in this group is the case in which religious delusions were probably based upon hallucinations for which hallucinations an isolated brain lesion was found, very probably correlatable with the hallucinosis.

The patient must avoid wearing anything, such as a garter, which constricts the limb, and any obvious cause of direct pressure on the pelvic veins, such as a tumour, persistent constipation, or an ill-fitting truss, should be removed. Cardiac, renal, or pulmonary causes of venous congestion must also be treated, and the functions of the liver regulated.

This may be observed in sarcoma of the kidney, the growth taking place along the renal vein until it projects into the vena cava. [Illustration: FIG.

It may extend upwards under cover of the ribs, downwards towards the pelvis, or backward towards the loin. On palpation a systolic thrill may be detected, but the presence of a murmur is neither constant nor characteristic. Pain is usually present; it may be neuralgic in character, or may simulate renal colic.

Branch from renal vein. 3. Small artery branches, one of which enters a Malpighian capsule . 6. Small vein leaving the capsule and branching into the capillaries which surround the uriniferous tubules. 4. Small veins which receive blood from the second set of capillaries. 8. Tubule showing lining of secreting cells.

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