B. Dysenteriæ As a Cause of Infectious Diarrhea in Infants

Carl Ten Broeck, Frank Garm Norbury
1916 Boston Medical and Surgical Journal  
man, but seems to me to be at variance with clinical observations. It is a matter of common knowledge that in a patient with a fresh, acute, severe colon bacillus infection, the administration of urotropin efficiently, with the maintenance of an acid urine, will within twentyfour hours eliminate the fever, diminish tho tenderness and stop the chills. I am unable to conceive how such a result could accrue from a drug which acts only on the bacilli in the bladder, and while I am prepared to admit
more » ... m prepared to admit that its most powerful action is in the lower urinary tract, I cannot avoid the conclusion that it acts at the level of the renal pelvis, and probably even in the convoluted tubule. There is no lesion produced by the colon bacillus which corresponds in severity to the hyperacute lesion produced by the coccus. I believe it to be doubtful whether there is any lesion of the kidney produced by the colon bacillus, which in its acute form cannot be managed by formaldehyde-containing drugs, properly administered. The serious lesions of the kidney produced by the colon bacillus, are the late result of the infection, the more or less complete destruction of the kidney, which amounts practically to a pyonephrosis. The most important discussable problems of colon bacillus infections are those concerning the final removal of the bacilli from the renal pelvis. A series of observations during the last year bear interestingly upon this question. The test of final removal of bacilli is, of course, persistently sterile bladder urine. In this series it early appeared that the most acute cases, that is to say, those with severe onset and high temperature, recover with
doi:10.1056/nejm191606011742204 fatcat:54kelibw6fhh7mdj65wyseqree