OCCURRENCE OF CAUSATIVE AGENTS. 157 



phenomenon is the result, in some cases, of fermentation of 

 the sugar in the urine through the activity of microorgan- 

 isms ; in other cases special varieties of coli-bacilli (aero- 

 genes, etc.), characterized by abundant production of gas, 

 have been cultivated from such urine. In one such case 

 the gases formed consisted, in addition to carbon dioxid, of 

 free nitrogen and hydrogen. 



NEPHRITIS. 



A bacterial origin has been ascribed 



1. Primary infectious nephritis. 



2. The nephritis occurring as a complication of infec- 

 tious diseases, including the septic. 



Streptococci have repeatedly been found in association 

 with acute nephritis, and both in the urine, from which 

 they disappeared with the termination of the disease, and 

 after death in the kidneys, in which they were visible in the 

 vessels, in the epithelium, and in tube-casts. Acute nephri- 

 tis has been induced also experimentally in animals by 

 injection of streptococci into the blood. Under these con- 

 ditions a large number of streptococci at first appeared in 

 the urine, but these disappeared later. The disease, how- 

 ever, progressed and terminated fatally, but no cocci were 

 demonstrable in the kidneys after death. This observation 

 indicates that nephritis may be of bacterial origin without 

 bacteria being found in the kidneys after death (Mannaberg). 

 The passage of the bacteria through the kidneys may suf- 

 fice under certain circumstances to excite the anatomic in- 

 flammatory process, which may then pursue its further course 

 independently of them. In the majority of cases of acute 

 primary nephritis bacteria are, as a rule, found in the kid- 

 neys. 



A variety of inflammation of the kidney excited by 

 Jbacteria appears further at times to present itself from the 

 beginning as a chronic nephritis. In the morbid condition 

 of slow course induced by Gharrin in rabbits by inoculation 

 with pyocyaneus, chronic nephritis was found repeatedly. 



In some cases of complicating nephritis the exciting 

 agents of the primary disease have been present. Thus, 

 typhoid-bacilli have been found in the kidneys in associa- 

 tion with typhoid nephritis ; diplococci, in association with 

 pneumonic nephritis ; and spirilla of relapsing fever, in the 



