64 ELIMINATION OF PATHOGENIC MICRO-ORGANISMS. 



which no inflammatory changes had as yet occurred, numerous 

 bacilli. They were also found in the epithelial cells of a convo- 

 luted capillary vessel. The author was also able to demonstrate 

 that the deposits in the kidney occurred around the capillary ves- 

 sels in the glomeruli, often including the latter completely. He 

 believes that the bacilli migrate from the glomeruli into the sur- 

 rounding tissue, when they give rise to miliary nodules. In cases 

 of tuberculosis of the kidneys the number and arrangement of the 

 bacilli, as they are found in the urine, are characteristic of this 

 disease. 



Moupurgo (Schmidt's Jahrbucher, B. ccxii. p. 128) found in the 

 urine of a woman suffering from renal tuberculosis numerous 

 bacilli arranged in groups resembling the letter " S," an appear- 

 ance which is only observed in pure cultures. Koch described this 

 bacteriological condition in a case of miliary tuberculosis. For 

 such a culture to form in the genito-uriuary apparatus, it is neces- 

 sary that the bacilli should be located in a place where they are 

 not washed away by the urine, and where they find favorable soil 

 for their growth, conditions which are only furnished in the 

 kidney. 



Neumann ("Ueber die diaguostische Bedeutung der Bakterio- 

 logischen Untersuchungen bei inneren Krankheiten, Berl. Idin. 

 Wochensehrift, Nos. 7, 8, 9, 1888) found the specific microbes in 

 the urine in cases of typhus, septicaemia, and pyaemia. In a case 

 of acute endocarditis and acute osteomyelitis, he cultivated from 

 the urine the staphylococcus pyogenes aureus. He believes that 

 the microorganisms which circulate in the blood localize in the 

 capillary vessels of the kidney, where they often cause minute, 

 multiple lesions without implication of the entire parenchyma of 

 the organ. Through the altered tissues some of the microbes enter 

 the tubuli uriniferi and are eliminated with the urine. 



Seitz found the bacillus of typhus in the urine in 2 out of 7 

 cases, Konjajeff in 3 out of 20 cases, and Hueppe only once in 16 

 cases, Neumann in 8 out of 48 cases. The last observer ("Ueber 

 Typhus Bacillen irn Urin," Berl. Jclin. Wochenschrift, February 10, 

 1890) in some instances found them so numerous that under the 

 microscope the urine appeared like a fluid culture. In these cases 

 the bacillus multiplies in the bladder. In two cases he also found 

 the streptococcus pyogenes, an occurrence which he considered as 

 an evidence of the existence of complications. 



Philipowicz ( u Ueber das Auftreten pathogener Microorgau- 

 ismen im Harue," Wiener med. Blatter, 1885, No. 22) found the 

 bacillus of tuberculosis not only in three cases of tubercular pyelo- 

 nephritis, but also in cases of acute miliary tuberculosis. If the 

 organisms were not present in sufficient number for detection by 



