CHAPTER LXXXV 



DISEASES OF THE URINARY ORGANS 



General remarks — Bilharziosis — Urinary amoebiasis — Oxaluria — Urinary 

 myiasis and canthariasis- — Chyluria — Mycological urinary tests — Test for 

 quinine in the urine — References. 



GENERAL REMARKS. 



Renal disease in all its forms is frequently met with in the tropics, 

 where nephrolithiasis, pyonephrosis, and pyelitis, with all their 

 associated phenomena, are by no means rare. Stone in the bladder 

 is common in certain regions, as is prostatic hypertrophy. But 

 the only disease which really concerns us in this work is urinary 

 bilharziosis, caused by Schistosoma hcBmatohmm. Tumours of 

 the bladder are not common in our experience. Prostatic abscess 

 is met with at times. We have observed various mycoses of the 

 genito- urinary organs due to fungi of the genera nocardia, asper- 

 gillus, monilia, cladosporium. Native children in some parts of 

 Africa (Sudan) suffer very often from a complaint called by the 

 Arabs ' har boul,' characterized by severe burning on passing urine. 

 This condition is due to concentrated acid urine and the presence of 

 gravel. Cystinuria is rare, but we have met with a case. 



In the present war a form of nephritis has been noticed in soldiers 

 in the trenches (trench nephritis). 



BILHARZIOSIS. 



Synonyms. — Urinary schistosomiasis, Endemic haematuria, Bilharzia disease. 



Definition.- — Bilharziosis is infection with Schistosoma hcema- 

 tohium Bilharz, 1852, the eggs of which irritate and invade the 

 urinary tract, and cause haematuria and cystitis. 



History. — The disease has been endemic in Egypt since ancient 

 times, Ruffer having demonstrated calcified eggs of S. hcBmatohium 

 in mummies of the twentieth dynasty (about 1250-ioooB.c.). Hse- 

 maturia was much noticed by the French army surgeons in 179Q 

 to 1801; but it was not till 1851 that Bilharz made the discovery 

 that the disease was due to 5. hcematohium. 



Climatology. — Bilharziosis is prevalent in Africa, especially in 

 Egypt and the Cape, but it is also met with in Asia, in India, S5n:ia, 



1926 



