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August 1, 1977

The Great Crusade (or Will the Real Pyelonephritis Please Stand Up)

Author Affiliations

St Joseph Hospital Orange, Calif

JAMA. 1977;238(5):427. doi:10.1001/jama.1977.03280050067028

There was a time in the beginning of the second half of the 20th century when nephrologists led a crusade to enshrine pyelonephritis as their fiercest and most destructive god. Led by a gentle though dedicated saint, they swept all opposition before them with frightening phrases like "20% of the population," "leading cause of uremia," "important cause of hypertension, premature labor, preeclampsia and baldness." Heretics, particularly among the urologists, were diligently hunted and properly humbled for keeping their hats on in the presence of the pyelonephritologists. Those caught with catheters in their hands were forced to run the gauntlet midst jeering medical students. Worse punishments were dealt to the skeptics, ie, those who wondered if bacilluria should really be treated for six months or more.

The Great Kidney in the sky was sorely vexed at these follies and sent down among his children a warrior named KIM-EL-STEEL (whom he had