PERINEPHRITIC ABSCESS; OPERATION; RECOVERY.

Acute inflammation resulting in suppuration in the connective tissue surrounding the kidney must be a rare disease. The literature in the medical journals is exceedingly scant, and but brief mention is made of the affection in the books. Yet we can hardly expect it to be infrequent when we consider its etiology. Injury is supposed to be the most frequent cause; next, exposure to cold, which is questioned by some, but undoubtedly is a cause; previous suppurative nephritis or pyelitis; extension of pelvic cellulitis; operations on the rectum; inflammatory affections about the bladder; psoas abscess; typhlitis and perityphlitis. Well authenticated cases have been reported in children, although by some this has been denied.

The symptoms are said to be local pain, shooting downwards; chilliness, followed by fever; malaise; nausea; anorexia; coated tongue; rigors and profuse sweats; emaciation; obstinate constipation. Deepseated fluctuation may be detected, but it may be very late.