UKINE EXAMINATION. 73 



(^d) Pus cells (leucocytes) are found in all irritative 

 or inflammatory lesions of the urinary tract. Only 

 rarely are they found alone, (rupture of abscess into 

 passages). As a rule we find, and must consider the 

 presence of albumin, epithelium or casts, as well as the 

 chemical characters of the urine, in determining the 

 site of lesion. 



3. Bacteria in the urine may be derived from the 

 urinary passages or may enter the urine after its pass- 

 age from the body (putrefaction). 



The bacteria which may be found in affections of 

 the urinary tract are as follows: 



(a) The Tubercle bacillus is found in Tuberculosis 

 of any part of the urinary tract. It is examined for as 

 described at page 32. 



(6) Occasionally certain bacteria which ma^ be ex- 

 creted through the kidney, multiply in the passages ex- 

 citing a bacteriuria. This is seen occasionally after 

 Typhoid fever and in some infections with the Bacillus 

 coli communis and more rarely with other microbes 

 during the course of a septicaemia or pyaemia. 



(c) Bacteria may make their way to the bladder and 

 upper urinary passages by being introduced through 

 urethra on catheters, etc. This usually excites the 

 condition of ammoniacal cystitis and by extension gives 

 rise to a form of " s.urgical " kidney. 



These three forms must be distinguished from the 

 bacteria which enter and cause putrefaction of the urine 

 after its passage from the bladder. 



