64 DISEASES OF THE PELVIS OF THE KIDNEYS AND URETERS. 



which they have spasmodically grasped, are relaxed by the narcot- 

 ism induced by the opium. If the opium given internally be vom- 

 ited, a subcutaneous injection of morphine may be used. Inhala- 

 tion of chloroform vapor seems to have an action similar to that of 

 the opium, and is the next best remedy. In like manner, a copious 

 blood-letting may be of service, from the relaxation to which it 

 gives rise ; but in most cases this may be dispensed with. The 

 patient, however, who is demoralized by pain and terror, will not 

 be satisfied by the mere hourly administration of a powder and the 

 inhalation of chloroform. He will loudly demand that something 

 more be done for him, and, as a matter of humanity, we should 

 yield to his entreaty. If circumstances permit, let him. make use of 

 a warm sitz-bath or complete bath. It has also often been recom- 

 mended to seat the patient naked upon a stool, and to lay his bare 

 feet upon a cold floor. As a beverage, copious draughts of some 

 mineral water, containing carbonic acid, should be prescribed, in 

 order, if possible, that the urine pressing after the stone niay drive 

 it before it into the bladder. 



CHAPTEK IV. 



CABCINOMA AND TUBERCULOSIS OF THE' PELVIS OP THE KIDNEYS 

 AND OF THE UBETEES. 



CARCINOMA of the urinary passages is rare. It scarcely ever 

 occurs except where cancer of other organs, especially of the kid- 

 ney, extends into the walls of the renal pelvis. In rare instances, 

 independent nodules of cancer appear in the pelvis of the kidney 

 and ureters, accompanying carcinoma of the bladder or kidney. 

 Tubercle of the uriniferous apparatus has already been alluded to 

 in treating of tuberculosis of the kidney, and was there stated to 

 be a partial manifestation of a general disposition to tubercle, in- 

 volving the testicle, prostate, seminal vesicles, and kidney. The 

 diffuse caseous decomposition, which the mucous membrane of the 

 urinary passages presents, cannot always be referred to the forma- 

 tion and softening of discrete tubercular granulations ; although 

 sometimes nodules as large as a millet-seed, either in groups or dis- 

 crete, and (where these have broken down) round or irregular ulcer- 

 ations, are found upon the mucous membrane. Sometimes the uni- 

 form proliferation of cells and their caseous metamorphosis convert 

 the inner wall of the ureter and of the pelvis of the kidney into a 

 yellow pultaceous mass. In other places the degenerated mucous 



