An American text-book of genito-urinary diseases, syphilis and diseases of the skin . i-mary phlegmons, and run a rapid and severe course ; or the inflammation maybe propagated from contiguous organs other than the kidney, as the lumbarspine, pelvic cellulitis, appendicitis, etc. Abscesses of the perirenal tissues usually rupture externally in the loin,but they may burst into the pleura or lung, the intestine or peritoneum, orthey may burrow downward through the iliac fossa to the groin and perforatethe skin. Etiology.—All of these forms of suppuration are caused by the presenceand growth of o
An American text-book of genito-urinary diseases, syphilis and diseases of the skin . i-mary phlegmons, and run a rapid and severe course ; or the inflammation maybe propagated from contiguous organs other than the kidney, as the lumbarspine, pelvic cellulitis, appendicitis, etc. Abscesses of the perirenal tissues usually rupture externally in the loin,but they may burst into the pleura or lung, the intestine or peritoneum, orthey may burrow downward through the iliac fossa to the groin and perforatethe skin. Etiology.—All of these forms of suppuration are caused by the presenceand growth of one or other of the pyogenic bacteria, oftenest the goldencoccus, but not infrequently the common colon bacillus. The channels bywhich these bacteria reach the kidney, however, are quite varied. In the cases of miliary abscesses occurring in sepsis or complicatingmalignant endocarditis the blood conveys the bacteria, and the process isone of embolism, and suppuration goes on wherever the cocci happen tolodge. In suppurative nephritis due to infection from the pelvis of the kidney. Fig. 19!!.—Suppurative nephritis : 1, 2, and 3,abscess-cavities (specimen 238(5, Museum N. ). 556 THE SURGICAL DISEASES OF THE KIDNEY. the pelvis of the kidney is usually invaded by bacteria reaching it throughthe ureter from the bladder, where, as a rule, they are present as the resultof instrumentation or the extension of inflammations of the urethra. The conditions which call for the introduction of instruments into thebladder are therefore usually the antecedents of this type of nephritis, andin such cases one finds an acute or chronic cystitis due to gonorrhea orstrictures, or hypertrophy of the prostate, or produced by operations uponthe urethra or bladder, or, in cases of paraplegia, in consequence of cathe-terization. The inflammation originating in the bladder ascends the ureter and pelvisof the kidney and the straight tubules, and then excites the changes abovedescribed. If the pel
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