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descends entirely below the ribs, and the finger Toprol Xl Coupon may be pushed above it. Third degree. The kidney wanders over an ex- tensive area of the abdomen, anchored by its pedicle ; it may swing as low as the iliac fossa, Toprol Xl Vs Metoprolol Tartrate or across Generic Name For Toprol Xl the median line of the body, and the displaced kidney may form adhesions or become fixed in a false or abnormal position. Occurrence. — Kiester believes 2.5 per cent, of the population, Toprol Xl Generic Equivalent irrespective of sex or age, has movable kidneys. Wolkow and Delitzin found Generic Name For Toprol among 221 women sixty-six cases of movable kidney. Ede- bohls says 20 per cent, of all women have nephro- ptosis. In forty-eight cases of dilatation of stom- ach recently examined by Gilbride, in ei,ghteen patients, or 37.5 per cent, of those examined, ])tosis of one or more kidnc_ys was present. Einhorn states that enteroptosis is accompanied in most cases by a Toprol Xl Generic Name movable kidney. Glenard found in 3,788 patients 481 cases of nephroptosis, 12.7 per cent.; of these 2.7 per cent, was found in men and 22 per cent, in women. Stiller finds a majority of lean, nervous dyspeptics with wandering kidney and succussion, and Cost Of Toprol Xl also observes that in those cases the tenth rib is movable and the eleventh and twelfth not Toprol Xl Vs Metoprolol fixed to the border of the ribs, but free. Einhorn. from January i to December 31, 1900, saw 282 cases "of movable kidney, of which 77.3 per cent, were right, 2.1 left, and 20.6 ]icr cent, both; many of these were associated with splanchoptosis. September 21. 1907.] ULLMAN: NEPHROPTOSIS. 547 Movable kidnej^ occurs oftener in women than in men, Ebstein gives the proportion lOO to 15, Goelet 7 to I, Dietl 100 to I, Hahn i to 5.5. According to Landau, in a series of 100 cases six occurred in the first decade, two in the second, fifteen in the third, forty-three in the fourth, twent}-- one in the fifth, nine, in the sixth, and four in the seventh. It occurs more frequently in- those who have borne children, more in the lower classes than among the well to do, and oftener on the right than on the left side. The causes of the displacement may be due to a curvature of the spine or in Metoprolol Tartrate Vs Toprol Xl an enlargement of the Toprol Xl Generic Recall kidney from a new growth. Traumatisms, such as concussions of the pelvis, from falls, and collisions of railroads, are to be men- tioned, but too much weight should not be given these causes, for Toprol Xl 100 Mg the reason that were they the causes movable kidneys would be found more frequently in men more exposed to traumatic influences than women. The positive abdominal pressure assists to hold the Toprol Xl Vs Generic kidney in its normal position. If the intraab- dominal pressure is decreased and the abdominal wall becomes lax, a Is Toprol A Beta Blocker movable kidney may follow. Under this head as causative factors are frequent pregnancies and stretching of the abdominal walls by new growths or ascites. Landau states that malpositions of the uterus and annexa, such as retroversions and retroflexions, have much to do with producing nephroptosis and en- teroptosis. The close relationship of these organs to the ureter and bladder show how displacements can produce a downward traction on either ureter, Toprol Generic Equivalent dragging the kidney. This also would explain why many cases Generic For Toprol Xl of movable kidney occur in women among the poorer classes. It is on account of a Toprol Xl 50 Mg Recall lack of care following pregnancy ; getting up too early before the uterus has reverted to its normal size, and the uterus enlarged by its own gravity sinking into a false position. The wearing of corsets pro- duces a Is Toprol Xl A Beta Blocker pressure on the right lobe of tlie liver. This pressure is transmitted to tho right kidney lying below it. whereas the left kidney is protected by the stomach. Oppolzer states that any condition, such as cachexia, tuberculosis, and inanition, which produces a loss in th^ kidney capsule may produce wander- ing kidney, but this is not true in a majority Toprol Xl Beta Blocker of cases, for were it so, it would be observed in phthisical men also. Movable kidney is Metoprolol Vs Toprol Xl often hut a part picture of a Glenard's disease or sphlanclioptosis. Glenard states that no enteroptosis exists without movable kidney. In splanchoptosis the stomach, intestines, and often the spleen and liver descend. This lat- ter observation has often been demonstrated by

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