Prognostic Value of Creatinine in Nephritis. 41 



days. One case which presented an area of bronchopneumonia 

 still unresolved on the seventh day gave a growth of streptococci 

 from that area. Later than the seventh day the lungs contained 

 no streptococci. 



Microscopic examination of the sections made from lungs within 

 twenty-four hours after insufflation of the culture showed con- 

 gestion of all the vessels with the formation of thrombi in some of 

 them. The alveolar contents consisted of red cells and coagulated 

 serum, but there were practically no hemorrhages. On the second 

 day the microscope showed that the alveoli were packed with 

 polynuclear cells, little fibrin and many red blood cells. The 

 solid areas surrounded inflamed bronchi. Infiltration of the 

 framework of the lungs was present but not intense in any case. 

 An abscess had formed in one lobe in one of the three cases with 

 empyema. 



The pulmonary lesion produced by the insufflation of the 

 Streptococcus hemolyticus resembled the lesion found in human 

 lungs from which the same organism was cultivated in that it was 

 a bronchopneumonia with marked edema and a large amount of 

 hemorrhage; it differed however from the human lesion by the 

 lack of any tendency toward organization. In the experimental 

 series empyema occurred in 12 per cent, of the cases and a pul- 

 monary abscess was present only once. 



25 (1400) 



The prognostic value of the creatinine of the blood in nephritis. 



By Victor C. Myers and John A. Killian. 



[From the Laboratory of Pathological Chemistry, New York Post- 

 Graduate Medical School and Hospital, New York.] 



At the May, 1914, meeting 1 attention was called to the accumu- 

 lation of creatinine in the blood in advanced chronic interstitial 

 nephritis, data being reported on two cases at that time. It was 

 then suggested that the retention of creatinine might be of etio- 

 logical importance in uremia on account of its containing the toxic 

 guanidine group, and further that the creatinine might be of con- 

 siderable prognostic value in advanced nephritis. Further study 



1 Myers and Fine, Proc. Soc. Exp. Biol, and Med., May 20, 1914, xi., p. 132. 



