Antall József szerk.: Orvostörténeti közlemények 60-61. (Budapest, 1971)

KISEBB KÖZLEMÉNYEK — ELŐADÁSOK - Kótay Pál: Százéves a vesesebészet (angol nyelven)

kidney, if its ureter is ligated. Thus, he presumed that the removal of the kidney could be avoided. But the ligation of the ureter proved to be impossible because its proximal end was situated much higher than—and at a considerable distance from the orifice of the abdominal fistula. In two instances and for longer periods he allowed the area to be corroded by rods of lapis lazuli, believing that the large amount of coagulum thus formed will block the excretion of the urine. In fact, this is what actually happened, but shortly the start of an unbearable spasmodic pain, a shivering-fit and a high fever indicated the presence of a serious infection, the onset of a septic condition. The patient was constantly vomiting and "streaming with perspiration". The accumulated urine has finally forced its way through the artificially created barrier—and once more started to flow freely. Under these circumstances, the only choice left to him was: either let the patient return home without being cured or attempt to remove the kidney. Three problems, to which he couldn't answer as yet, were tormenting his mind : 1. Can a man continue to live if one of his kidneys is removed ? The pathological descriptions have mentioned a number of cases in which one of the kidneys got atrophied, while the activity of the other organ was so enhanced that it assumed the work of both. These changes, however, are the result of slow processes during which the intact organ had sufficient time to get adapted to the increased activity, as well as to the changed conditions. Nevertheless, something that nobody knew is what would happen if one of the kidneys is suddenly removed. 2. Does the urine inundate the whole organism and if so, would it result in its infection? 3. Would the heart be able to support this excessive additional work? He thought that if the operation should end in sudden death, public opinion would no doubt consider him as an irresponsible adventurer and denounce him as such. So that he may get an answer to these questions, Gustav Simon decided to conduct various experiments on dogs. Aided by his assistant, he removed —under chloroform narcosis—one of the kidneys of ten dogs belonging to various races and ages. Three dogs succumbed immediately after the operation. The other seven survived the intervention. During the 24 hours following the operation, the dogs were lying dizzily, feebly, were constantly vomiting, refused to eat and drink. Simon feared that this is a sure indication of uraemia. After this, some of the dogs were operated without narcosis. Immediately after the operation these animals could walk with relative strength, failed to vomit and accepted both food and water. Gustav Simon continued his experiments. If occasionally he lost an animal, this was due either to the existence of peritonitis or to a strong haercorrhage occurring either during or after the operation ; because in the beginning haemorrhages couldn't be controlled as easily as nowadays. As to the surviving animals, these were sacrificed after varying periods. In all these cases it was possible to establish that the remaining kidney has grown to a size almost twice than that which has been removed, taking over its function as well. If the data furnished by the experimental animals affords the possibility of drawing certain conclusions capable of being applied to men, then Gustav