Somewhat more than three years ago one of us (H. W. McK.) became dissatisfied with our management of the injured kidney, feeling that our treatment followed no preformed plan. For this reason, a study was made of all of the cases which we had seen at the Charlotte Memorial Hospital since 1940 in an attempt to ascertain whether we might not reach some conclusions which would permit the formulation of a working plan for the proper diagnosis and management in these cases.1 As a result of this study the following conclusions were reached: (1) we were not taking sufficient steps to diagnose the exact nature of the injury, that is, whether the kidney was merely contused or frankly ruptured; (2) we were content to follow the generally accepted mode of so-called conservative nonoperative management even in cases in which actual rupture of the kidney was demonstrated; (3) we were