weeks of treatment not to allow the patient to sit or stand, or if she should be unable to avoid the occasional need for these positions, an abdominal binder must be applied by the nurse and drawn tightly before she moves.  The masseuse is directed to avoid any movements which might further displace the organ, and may cautiously push it upward and hold it there with one hand while with the other the manipulation of the abdomen is performed.  However long it may require, the patient should not get up until examinations, supine, lateral, prone, and erect, combine to assure us that the kidney is replaced.  Repeated investigation of this point will be required,—­for the kidney will sometimes be in place for a little while and next day or even a few hours later have slipped down again.  Before any exertion is permitted, even ordinary walking, an accurate close-fitting abdominal belt with a kidney-pad should be applied.  Those kept in stock are seldom properly adjusted, and usually have the pad in the wrong place.  If rightly made, they can be worn with comfort and tight enough to be useful.  If not rightly made, they are useless instruments of torture.

Mrs. Y., aet. fifty-six, was sent to Dr. J.K.  Mitchell by Professor Osler for treatment.  She had all the usual intestinal derangements and discomforts attendant upon a floating kidney:  constipation alternated with diarrhoea, or rather with a sort of intestinal incontinence; vague pains in the back, flanks, and stomach were frequent; attacks of acute pain began in the right hypogastrium and ran down to the symphysis or into the groin; she had constant flatulence, weight, and oppression after food; was pale, flabby, and emaciated, but had no emotional or nervous symptoms except an annoying amount of insomnia.  The lower border of the stomach was fully two inches below the navel in the middle-line, even when only a glass of water had been taken.  It was a little lower after a small meal.  The colon was distended and very variable in position, probably changing its relations with the landmarks as it happened to be more or less filled with food or gases.  The abdominal walls were flabby, relaxed, and pendulous, and the whole surface tender.  The patient gave a history of sudden loss of flesh with almost no reason some three years before, and increasing indigestion in all forms ever since.  The tenderness made careful abdominal study difficult, but lessened enough after a few days in bed to permit the perception of a displacement of the right kidney, whose lower edge could be felt on a level with the umbilicus and two inches to the right of it.  No change of position would bring it any lower.  Examined with the patient prone, two-thirds of the kidney could be outlined, extremely tender, and causing nausea and sinking if pressed upon.