LATE FELLOW Ini SURGERY, M A Y 0 CLINIC, ROCHESTER, MINUESOTA, U . 8 . A .THE object of these studies was to investigate further the advantages and limitaticns of intravenous pyelography with uroselectan. One of us (R. J. W.21) has already recorded his earliest experiences. We feel that the selected cases described below may be deemed of sufficient interest to be worthy of record in view of the facts that intravenous pyelography is still in its infancy and that only by the accumulation and consideration of recorded experience can the true value of this new method of diagnosis be properly assessed.
HISTORY.It map be of interest to survey briefly the history of the attempts that have been made to delineate the outline of the interior of the urinary tract with media opaque to the X rays, at first by the injection of such substances through the ureter catheter, and more recently by virtue of their excretion by the kidneys following intravenous or oral administration.Voelcker and Lichtenberg16 in 1906 were the first to report on the use of such a substance, introducing colloidal silver into the renal pelvis through the ureter catheter. thus giving to urology the science and art of pyelography. They found that this substance, in addition to being expensive, gave rise to unpleasant, and at times alarming, constitutional rcactions. But despite its use for some years by one of us (R. J . W.) no untoward effects have ever been experienced.Kclly and Lewis7 in 1913 were the first to suggest the use of a halogen compound, and recommended silver iodide cmulsion, claiming that. in addition t o being less irritating and safer than the colloidal silver, it was also much cleaner to work with.Braasch and Mann,2 working at the Mayo Clinic in 1916, demonstrated that many silver compounds, when retained in the pelvis of the kidney or injected under pressure, produced areas of cortical necrosis. Other reports by Praetorius12 (1919), Schiissler14 (1920), and Barreaul (1921) have confirmed the opinion of Braa3ch and Mann in pointing out the danger and unsuitability of injecting silver compounds into the renal pelvis.Burns,3 of thc Johns Hopkins Hospital, in 1915 reported satisfactory results with thorium nitrate, the aqueous solution being neutralized by sodium hydroxide in the presence of a sufficient amount of sodium ritrate to prevent the precipitation of the thorium. Later4 he made an extensive report 011 his further investigations regarding the use of this medium, which gained