CO129-468 - Governor Sir Stubbs - 1921 [6-8] — Page 80

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Casce in which the genitourinary tract has been involved have bemi comparatively

few in my mxperimɩce here. The majority of these showed merely a few miliary tuber-

ales as maboli in the glomerular capillaries, constituting part of a general bamÃO

infection, As examples of cases in which the kidney was found fosaliy sấŸooted in

conjunction with widespread tuberculosis may be mentioned Now 54,72,65,243 and 271.

The last merita special mention on account of the peculiar distribution. The exien-

siye alimsitary infection-tuberculous uiosration of both large and mall intestinec

casented adherent desentarás glanda, extensive infectiorm of the peritoneus--and, the

equal distribution of tuberales throughout both lungs would point to the alimentary

canal as the primary portal of antay. The condition of the kidneys,howevaz,doen nat

support the idea of a hamatogenous origin from entrance of tuberals basilli indo

the general siroulation from the lungs. Bach kidney showed a large focus in a sinlă.

ar situation at the lower pole,as larga na a sobnut, and cassous,most advanced at the

margin between the cortex and a pyramid, and passing in as if later it would die-

charge into the palvis. No naked-eye involveumėt of the ureters was detected, The

fosi gave the impression that they arose from affection of the tubules in courses of

exoration (as mentioned by Assheff and Israel). The foci were each in a more advano-

ed state than a few smaller,pin-head and wiliary tubercles in the cortical area of

the right, kidney which had more likely arisen by hawatogenous infection. The kidney

foul appeared of considerably older standing than the pulmonary condition and showed

more advanced saaukkion than the mediastinal glands but less than the mesenteric,

There were no indications of an ascending infection from lower down the urinary

traat. Other vissora,þiver and splom, showed sparse tubercles only and these were, in

the formar et all events, confined to the peritoneal surface. Briefly, the age of the

kidney condition appeared to be less than that of the alimentary but more that: that

of the pulzonary, and the mode of involvement is obscure.

Others of interest azei No 47,in which sach kidney contained a tubareuìous mási

towards the upper pola, the size of a colaut, without my indication of any miliary

or other infection in the remainder of the organ; nor did the other viscera shor

tuberoles in their interior, though ting were preset on the murfree of the liver

and apåsen, Nevertheless sech was shaped liice an inferet and was almost certainly

of haematogenous origin. No 98. In this the kidney condition was advanced; bath

ware affected,but the right more than the left. The onlyeos were hollowed and had

communicated, the suvity being lined by tuberculous deposit. No 229,m infant of only 9 months,showed generalised tuberculosis and in addition to miliary infestien of the kidneys,ons calyx in the left was hollowed out and lined by tuberculous

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