1932 



DISEASES OF THE URINARY ORGANS 



a vesicular nucleus and phagocyted red blood-corpuscles, while 

 cystic stages of the same organism were also observed. There is, 

 in our opinion, no reason to doubt that this is the same species as the 

 organism variously known at the present time as Loeschia histolytica 

 (Schaudinn, 1903, emendavit Walker, 191 1) ; Entamceha histolytica 

 Schaudinn, 1903; Entamceha tetragena Viereck, 1907; Amceba 

 dysenteries Councilman and Lafleur, 1891; and Amoeba coli Loesch, 

 1875 ; and by various other names. 



The unpleasant point is that if the rules of zoological nomen- 

 clature are pressed we ought to call the amoeba of dysentery by 

 Loesch's name. 



The following cases are known to us: — • 



(1) Baelz's patient was dying from pulmonary tuberculosis, and it 

 was only shortly before death that haematuria associated with severe 

 tenesmus of the bladder set in, and Baelz considered that the bladder 

 as well as the vagina was infected, but it is not evident from 

 abstracts of his paper that any post-mortem examination was made. 



(2) In Jiirgens' 1892 case the amoebae were found by post-mortem 

 examination to come from mucous cysts in the bladder of an old 

 woman who had suffered, from cystitis, and in whose vagina .they 

 were also found. 



(3) In 1911 Craig found Loeschia histolytica Schaudinn, 1903, 

 in an infection of the bladder in which the autopsy showed a minute 

 fistula between the ulcerated intestine and the bladder. 



(4) Lynn's 1914 Costa Rica case seems to have been probably 

 caused by a vesical lesion, as the patient is reported to have felt ' a 

 pain in the trigonum vesicae at the end of micturition.' He responded 

 very well to emetine treatment, as it is stated * in the course of 

 five days the vesicle tenesmus was relieved and the urine cleared ' ; 

 moreover, there was no return of the symptoms after one month. 



(5) and (6) Scott Macfie's second case was probably a bladder 

 infection associated with bilharziosis, while his third and fully 

 described case was probably an infection of the genito-urinary tract 

 in the neighbourhood of the seminal vesicles. 



High up in the Urinary Tract. — In these cases the site of infection 

 is probably in the pelvis of the kidney. 



(7) Posner's 1893 Berlin case began with a rigor and the passage 

 of urine tinged with blood, which, when examined, showed red and 

 white blood-corpuscles, hyaline and granular casts, and large 

 granular bodies 50 by 28 microns, which slowly altered their shape, 

 and which contained, among other things, red blood-corpuscles and 

 one or more nuclei and some vacuoles. Posner, probably correctly, 

 came to the conclusion that the pelvis of the kidney was affected, 

 but seems to have considered that this infection began in the bladder. 



(8) A similar case exhibiting signs of pyelitis without any vesical 

 symptoms has been recorded by Chalmers and O'Farrell in the 

 Anglo-Egyptian Sudan. 



Site in the Urinary Tract Unknown. — (9) We have been unable 

 to refer to the original papers written by Wijnhoff, by Jeffries, and 



