6o 
THOMPSON YATES LABORATORIES REPORT 
operation, and appeared healthy ; there were no secondary growths found. The 
amount of urine increased after the operation, the average for the seven following 
days being 14*7 ounces. The total urea passed in twenty-four hours was estimated 
on thirteen occasions after operation, the average being i28 - 8 grains. 
The charts shew an apyrexic curve, with the exception of three unexplained 
and unimportant rises. The child increased in weight, and his general condition on 
leaving hospital was excellent. The dark colouration of the skin became distinctly 
more noticeable. He was seen on December 28, 1900, when to all appearance he 
was in robust health. 
Pathological Report— -The growth weighs thirty-eight ounces. It is oval in shape, 
but the outline is very irregular owing to the projection of lobes of growth, chiefly on 
the inner aspect ; one very prominent lobe projects forwards and upwards from the 
inner and anterior margin. The whole mass is covered by a fibrous capsule ; this is 
comparatively thinned over the prominent portions of the lobes, but strongly marked 
in the intervals between them. At the lower and external pole lie the remains of the 
renal tissue ; the upper border of this is represented by a sharp edge on the outer 
aspect of the mass, which can be lifted away from the growth with the handle of a 
knife ; the handle easily separates kidney and growth inwards and downwards for 
two inches ; below this they appear to be incorporated with one another. The renal 
tissue forms the outer and lower angle, the inferior border, and the greater part of 
the inner and lower angle of the tumour. The renal artery is seen between renal 
tissue and growth on the inner aspect, in front of a line bisecting the mass from the 
jiiner side ; it disappears under the edge of the compressed renal tissue, but by 
separating this from the growth, the artery can be traced between them for about an 
inch, when it enters the kidney substance ; the direction of the artery is downwards, 
forwards, outwards, and then backwards to the hilum. 
The stump of the severed ureter lies behind the line bisecting the growth from 
within outwards ; its direction is almost directly downwards and slightly outwards, 
round the inferior and inner pole of the new growth to end, after about half an inch 
of course between kidney and growth, in the pelvis. Its termination could not of 
course be seen before bisecting the mass. This was done from the inner aspect 
and the two halves separated. 
The renal tissue was then seen to be represented by a strip about 5 m.m. in 
thickness for the most part, but in the lower half of this a column of new growth, 
spherical in section, bulges into the pelvis, and is bounded on the outside by the remains 
of cortex, and on the inside by the pelvic lining. 
This column forms a valuable clue to the exact anatomical relationship and the 
place of origin of the growth, as it is in direct continuity with the main mass. The 
pelvis on section is crescent shaped, the concavity of the crescent being occupied by the 
inferior' border of the growth, and no renal tissue is distinguishable here outside the 
