THE PUBLIC HEALTH ASPECTS OF LEPROSY IN THE UNITED STATES
Journal of the American Medical Association (JAMA)
tion. This information is of value from the point of view of prognosis and treatment of cases of chronic pyelitis and pyelonephritis. If the infection is a pure pyelitis, pelvic lavage usually gives brilliant results, while in pyelonephritis the results of pelvic lavage are of only comparatively slight value. There is another class of eases whose recognition is absolutely impossible without the employment of functional tests. I refer to the infantile kidney. The urine secreted by these kidneys
... ay be perfectly normal, but is small in amount and the presence of such an anomaly can be suspected only when functional estimations are made. Recently, wo had a very striking instance of this in which a tuberculosis was present in the large, hypertrophied kidney. The function of this tuberculous kidney was six times that of the other kidney, the urine from which was perfectly normal in every respect, except that it was small in amount. These cases are probably not uncommon and it will be impossible to check them up in any other way than by a functional estimation. In the early cases of renal tuberculosis, if the disease is limited to a small area in the kidney, functional estimation may show little disturbance because there is little disturbance of function present. One has only to glance at the literature to realize the growing interest of the medical profession in the subject of renal function and the. practical unanimity of opinion regarding the value to be derived from functional studies.