534 DISEASES OF THE KIDNEYS. 



theless, calculus formation is also an important factor in producing 

 the disease. 



Many different agents are capable of producing jDyelo-nephritis. 

 Hofflich in 1891 described a bacillus about 2 to 3 micromillimetres 

 in length, which stained readily with aniline colours and with Gram 

 solution. Lucet in 1892 found a short bacillus which did not stain 

 with Gram, and later another thin bacillus which did. Kitt has 

 described cocci, but no other organisms. Masselin and Porcher dis- 

 covered a cocco-bacillus which stained with Gram and reproduced 

 the disease in an animal lent by Moussu, after a single intra-vesical 

 injection of the culture. Cadeac has met with staphylococci, and 

 Moussu has discovered various bacilli, some resembling the colon 

 bacillus, and pyogenic streptococci. 



There is no doubt that many different organisms may produce 

 pyelo-nephritis by ascending infection. The most common seem to 

 be forms of paracoli, such as the Bacillus urece. Moussu nevertheless 

 believes that Hofflich' s bacillus, w^hich was rediscovered by Porcher, is 

 that which produces typical pyelo-nephritis. It grows in the bladder 

 without producing cystitis, and is succeeded by an ascending infec- 

 tion of the ureters without causing primary ureteritis, the local inflam- 

 mation occurring chiefly, it would seem, in the pelvis and the kidney. 

 All the other organisms which Moussu has tested have caused lesions 

 of cystitis . and of ureteritis, together with those of pyelo-nephritis. 



In these latter cases the pyelo-nephritis assumes the acute form, 

 and is accompanied not infrequently by cellulitis and abscess forma- 

 tion in the tissue around the kidney. 



Symptoms. Pyelo-nephritis develops in one of two principal forms, 

 the slow chronic form, which is the most frequent, or an acute or 

 subacute form, much more rapid in its development. 



The chronic form for a time escapes notice. There is no doubt 

 that at first some general disturbance occurs, such as diminution of 

 appetite, disturbed nutrition, unhealthy general appearance, staring 

 of the coat, tightness of the hide, wasting, etc., but such symptoms 

 are in no wise characteristic, being found in all grave diseases. 



The signs only become really significant from the clinical standpoint 

 when the urine appears modified in character, and such modification 

 does not occur until the pelvis of the kidney and the kidneys them- 

 selves are already gravely diseased. 



The urine is then turbid, of a brownish colour, and charged with 

 sediment, filaments of mucin, pus corpuscles, and earthy phosphates. 

 On analysis it is found to contain more or less albumen. 



At a late stage it may even become glairy, blood-stained, or of 

 the colour of blood, and when the pelvis or the cdices of the kidney 



