Modern surgery, general and operative . Fig. 918.—Thompsons divulsor. gestion and probably favors infection. The bacteria most often found arepyogenic cocci, colon bacilli, and micro-organisms which cause putrefactionand decomposition of urea. The condition does not arise promptly, suddenly, and violently, as doesurethral fever, but begins rather insidiously after several days. Mr. Moullin^ thus describes the condition: So far as the broader features are concerned, the symptoms that presentthemselves in these cases are remarkably uniform. They do not begin atonce. Nearly always some
Modern surgery, general and operative . Fig. 918.—Thompsons divulsor. gestion and probably favors infection. The bacteria most often found arepyogenic cocci, colon bacilli, and micro-organisms which cause putrefactionand decomposition of urea. The condition does not arise promptly, suddenly, and violently, as doesurethral fever, but begins rather insidiously after several days. Mr. Moullin^ thus describes the condition: So far as the broader features are concerned, the symptoms that presentthemselves in these cases are remarkably uniform. They do not begin atonce. Nearly always some few days elapse before there is anything to excitesuspicion. Then the urine becomes cloudy, though it may still retain itsacid reaction. A small quantity of albumin, more than can be accountedfor by the amount of pus that is present, makes its appearance. Under the. Fig. 919.—Gouleys divulsor. microscope there are a few hyaline casts, perhaps a blood-corpuscle or two,numerous pus-corpuscles, and myriads of bacteria. The specific gravity islower than it ought to be, and is lower than it was before the catheter wasused. The total amount passed in the twenty-four hours may either increaseuntil it is as much as 7 or 8 pints, or diminish imtil it scarcely reaches20 oz. There is seldom any definite rigor, but there may be mmierous slightchills. The pulse grows more rapid and feeble. The tongue becomes red anddry. There is complete anorexia. Delirium sets in at night, and in a con-siderable proportion of cases the symptoms rapidly grow worse and worseimtil, at the end of a few days, the patient sinks into a semicomatose conditionfrom which he seldom rallies. Postmortem there are all the signs of recentacute cystitis and pyelonephritis. The mucous membrane lining the pelvis 1 Lancet, Sept. 10, 1898. 1370 Diseases and Injuries of the Genito-urinary Orga
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