246 Anatomy Applied to Medicine and Surgery. 



two especially, and then through these lumbar nerves, viz., 

 the ilio-hypogastric, ilio-inguinal, genito-crural, etc., to 

 their distribution. The action of the genito-crural is seen 

 in the retraction of the testicle a not uncommon symp- 

 tom in renal calculus, the retraction being due to the ac- 

 tion of the cremaster muscle which is supplied by this 

 nerve. 



Clinical Examination. Percussion of the kid- 

 ney. No definite information can be obtained by percus- 

 sion of the normal kidney, posteriorly, because of the 

 overlying mass of lumbar muscles, nor can any be obtain- 

 ed anteriorly on account of its deep situation in the abdo- 

 men. Again, it is impossible to recognize the kidney by 

 palpation, except very rarely, and then on the right side, 

 only, and in a very thin subject. Hence, when the normal 

 organ is palpable, it means that its attachments are lax 

 enough to permit its gliding more or less downwards 

 "movable" kidney. The term "movable," applied to the 

 kidney, has reference to its movement with or without its 

 fatty capsule, and, as a rule, behind the peritoneum. This 

 must be distinguished from "floating" kidney a congen- 

 ital condition, in which the kidney has a mesonephron so 

 that it is completely surrounded by peritoneum, and, 

 therefore, hangs free in the abdominal cavity. Movable 

 kidney is more common in women than in men (Ebstein 

 considers the proportion as seven to one ; Einhorn, ten to 

 one). Edebohls stated that 20% of womankind have 

 "movable" kidney. The right is displaced more often 

 than the left according to Rutner (1890), seven times; 

 to Greig Smith, four times, and to Einhorn, twenty times. 

 Movable kidney may be a part of visceroptosis or Glen- 

 ard's disease ; or it may be due to the corset or tight waist 

 band; or to relaxation of the abdominal walls (Sulzer) ; 

 or to disappearance of the fat around the kidney (Lan- 



