The admonition of the elder Gross, "never operate for stone unless you have one in your pocket," seems especially applicable to renal calculi. The reason for this failure lies not only in the inability of the surgeon to find the stone when present (although this, I grant, at times occurs to the most experienced), but also because there are a number of pathologic conditions whose symptoms simulate stone in the kidney most accurately. Some of these I wish to present for consideration as exemplified by several typical cases:
The first case is one of infected infarcts of the Kidney, with symptoms simulating renal calculus.
—J. N. S., aged 47, thin and spare, by occupation a cattle speculator, had had for ten days previous to operation constant pain referred to the region of the loin and right kidney. The pain was so severe that morphin had no effect,