Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
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Publisher: New York, London : D. Appleton and company

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nsin Regard to Pyuria.—The pus may be presentonly in the first part ofthe urine voided, or inall the urine, or princi-pally in that constitutingthe end of the micturi-tion. Under the samepathologic conditions theamount of pus varies from time to time, and, as already pointed out, there are always other pathologicelements in the urine which contains pus. A pyuria may or may not be asso-ciated with general symptoms, such as malaise, fever, leukocytosis, renal insuffi-ciency, etc. Frequently pain, tenderness, swelling in one part of the urinarytract in association with pyuria will indicate its source. Ofter, however, aswill be pointed out in the infectious diseases of the kidney, these symptoms areprominent by their absence. In tubercular kidneys the rule is for all the symp-toms to be those usually associated with diseases of the bladder. When only the first urine voided contains pus, which may be determinedby having the patient void in several glasses, carefully numbered, it is prac-
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FiG. 109.—Method of Obtaining Sterile UrineFROM Kidney. Rubber sleeve removed from glasscatheter. Urine allowed to flow directly into steriletest-tube. 218 PYURIA, HEMATURIA, PNEUMATURIA AND HEMOGLOBINURIA. tically conclusive evidence that the source in the male is the urethra, and in thefemale, either the urethra or the external genital organs. Pus which readilyseparates and falls to the bottom of a conical urine glass on standing is prac-tically always of vesical origin. When the pus does not separate it is either ofvesical or kidney origin. As already stated, pus casts point to the kidney. Fre-quently a low specific gravity urine associated with pus means kidney origin.Polyuria is one of the common symptoms of pyelitis. It must be borne in mindthat a cystitis and chronic interstitial nephritis may produce the same results.A differentiation can usually be made by the functional tests for kidney activityand a careful examination of the heart, arteries, and blood pressure. Whenalbum

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