Lupus Vulgaris

for sixteen years; another similarly for fifteen and a half years; and a third for thirteen years. In none of these three cases was ureteral catheterisation carried out. Deposits were present, when first seen, in prostate, vesiculw, or epididymis, and in all three tubercle bacilli were found in the urine. The diagnosis of kidney involvement was made by cystoscopic examination of the ureteral orifices. One early bilateral case is reported to be well except for an occasional "turn" of frequency, seven and a half years after the onset of symptoms. Lastly, in the other survivors, symptoms remain five years and under from the onset of their illness. These statistics support the contention that, with our present knowledge, operation remains the most hopeful method of treatment in tuberculosis of the kidney. If done early, before deep ulceration has taken place in the bladder, relief is often immediate. Even in late cases, if the other kidney is sound, the patient may still be cured. Deep ulceration of the bladder renders the prognosis less hopeful, especially as regards the relief of frequency of micturition. Even if healing takes place, the scarred and contracted bladder is unable to expand, and the patient is obliged to empty it at frequent intervals.