The bacteriological examination of the renal secretion in certain of the zymotic diseases, with subsidiary differential experiments / by C. J. Lewis.

  • Lewis C. J.
Date:
1901
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Licence: In copyright

Credit: The bacteriological examination of the renal secretion in certain of the zymotic diseases, with subsidiary differential experiments / by C. J. Lewis. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    testing might easily result in the acceptance of one of these as the genuine bacillus. Horton-Smith’s definition suggests the tests which should be applied, and is as follows:—“A bacillus which often showed long threads, which possessed high motility, which was provided with eight to twelve or more cilia, which, however long kept, did not produce gas in gelatin or dextrose-gelatin shake cultures, while growing well in the substance of those media; which, even after one month, did not produce indol in broth cultures, nor clot milk ; which, however, did produce slight acidity in milk after twenty-four hours; and which, lastly, gave a posit- ive reaction when tested with typhoid serum : then, and not till then, I think, one is justified in saying that it is really the i>. typhosus.” A\ ith this 1 entirely agree, except that I would alter the one word after in relation to the indol reaction to the word within, since 1 believe that no fresh typhoid bacillus gives the indol reaction in broth culture within one month, but some typhoid bacilli certainly do so later. This will be more fully referred to in a note on indol reaction in the latter part of this report. Briefly summarised, it appears from the accounts of these observers that—(1) Typhoid bacilluria is a condition of the later stages of the disease, and, if the type be a mild one, occurs with or without albuminuria of slight amount, but that it is more common in severe types, and then usually occurs in the third and fourth weeks, associated with a considerable quantity of albumin. (2) Pyuria is apt to accompany the bacilluria in a large pro- portion of cases. (3) It occurs in about 25 per cent, of all cases of enteric fever. (4) It is more a bladder condition than a renal one, and is possibly curable by antiseptic injections, or the admini- stration of antiseptic medicines. (5) The organism finds the urine a very suitable medium for growth, and when present it is found in almost pure culture and in enormous numbers. The only criticism ot this summary which I desire to add has reference to the prevalence, which I consider over-estimated. Bactcriuria in scarlet fever.—Since the specific organism of scailet ie\ ei can haidly be said to be as yet generally recognised, there is not much to be recorded as to its presence in the urine; but up to this time Ivlein s J\f. scarlatinas or Streptococcus scarlatinas, which appeals to be identical with the Streptococcus conylomeratus A jviiith, has most claim to recognition as the specific organism. It is necessary to note that this organism has not as yet been obtained in the urine of scarlet fever patients. Klein has published the results of his investigation of the urine in three cases during the stage of desquamation, and in none was a streptococcus found. Bacilluria in diphtheria.—The B. diphtherias (Klebs-Lbffler) has been found m the kidney in fatal cases of diphtheria, as well as m inoculated animals. Wright found it in the latter four times