TUBERCULOSIS OF THE KIDNEY is, in the majority of cases, associated with tuberculosis in other organs. The kidney is enlarged, sometimes very considerably, and cheesy masses are seen in the secret ing substance. This condition was for merly known as scrofulous kidney.
Symploms.—There is usually tender ness and swelling in the loin, accom panied by dull aching or dragging pain. Pus is almost invariably found in the urine in large amount; blood is com monly present; and in many cases tuber cle bacilli may be demonstrated. Vesical irritation and tenesmus are said to be very constant symptoms, and are thought to be due to tubercular deposits about the lower end of the ureter and in the blad der-wall. Irregular elevations of tem perature, rigors, and sweating occur, and there is loss of flesh and strength. The history and hectic character of the tem perature would be of aid in the differ ential diagnosis from other suppurative affections of the kidney; the finding of tubercle bacilli in the urine would be almost absolutely diagnostic.
Study of 415 eases of tuberculosis of the kidney. Tuberculosis is rarely, if ever, primary in the kidney, and the original focus is in sonic other organ in more direct contact with the external air in the majority of cases. The pres ence of the primary focus of disease in the body, even if the disease has been thoroughly eradicated from the urinary tract, makes the ultimate prognosis in these cases doubtful at least. Such foci may remain permanently quiescent, but they may also become excited to activ ity by a general low condition the system or by causes unknown to us. Garceau (Annals of Surg., Oct., 1902).