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We doctors are frequently reminded that the patient’s primary interest is to get a treatment to make him well. We feel that it is not necessary, as formerly it was thought to be, to stress the point that the prospect of such a happy result is increased if our treatment can be intelligently and accurately applied. Hence diagnosis is of primary importance. Right now would seem to be an opportune moment to speak of this, for possibly no branch of medicine has advanced more in diagnostic skill than the genito-urinary specialty. Before the present century our procedures were largely empirical. This is a striking example of a good word gone wrong. It means founded on experience. The trouble was that experience was largely similar to that of the elderly matron who felt competent to advise a young mother because she had had a dozen children of her own — ten of whom had died young.
Now blood examinations may show whether poisonous substances are accumulating in the blood when they should have been removed by the kidneys. A dye can be injected into the blood, and the amount found in the urine can be measured to test the function of the kidneys. The urologist passes an instrument into the bladder and from this threads catheters, that is, flexible tubes, into the ureters. Thus he tries out each kidney separately. Then he injects into these catheters a fluid which will show by X-ray. In this way he outlines the hollow portions of the kidneys and the ureters running down from them.
But all this use of instruments may have too many disadvantages for a sick patient. In this case a fluid may be injected into the blood and X-rays will then determine if the kidneys are excreting it. This method again tells of the function of each kidney and the presence of abnormalities. And X-rays may also tell of the presence of stones. These are a few hints of the accuracy with which the excretory system may now be studied.

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