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TREATMENT OF TUBERCULOSIS OF THE KIDNEY AND BLADDER BY NEPHRECTOMY.

LEONARD FREEMAN, M.D.
JAMA. 1906;XLVII(25):2047-2051. doi:10.1001/jama.1906.25210250001001.
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It has recently been recognized that tuberculosis of the kidney is much more common than was supposed, and considerable attention has been directed to its treatment by early nephrectomy. In this connection Senn has estimated that one out of every eighteen consumptives suffers from some form of genitourinary tuberculosis; while the Pathologic Institute at Prague, found 5.6 per cent. of renal involvement in autopsies on adult tuberculous patients, and Rillet and Barthez 15.7 per cent. in children.

For a long time it was believed, as taught by Guyon, that the tubercle bacillus seldom infected the kidneys through the blood, but almost invariably ascended through the ureters from the bladder. These views have undergone a radical change and the hematogenous origin is now commonly recognized. For instance, Schéde says: "It has been proved beyond all doubt, and is generally accepted, that the principal mode of infection is through the blood." Clinical

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