In cases of kidney injury in which recovery has occurred after nonoperative treatment, one is apt to overlook the late effects of such an injury to the kidney and the corresponding ureter. Only a few articles have thus far appeared which show the value of intravenous (excretory) and of ascending (retrograde) pyelography in the determination of how much damage has been done in these cases. The importance of the subject from the standpoint of industrial and ordinary accident insurance cannot be overestimated. In all cases thus far reported, the interval between the time of injury and that of the examination has been a relatively short one ; hence the report of a case in which the accident occurred twenty years before the reappearance of symptoms referable to the injured kidney may be of interest. A man, aged 39, while traveling in Europe had a sudden, symptomless hematuria. When I first saw