Selected researches in pathology / by Alex. Gunn Auld.

  • Auld, Alexander Gunn.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Selected researches in pathology / by Alex. Gunn Auld. Source: Wellcome Collection.

    58/172 (page 46)
    has led me to recognise two main divisions. In one the lesions of the glomeruli and of Bowman’s capsule are very- marked, and overshadow the other lesions; in the other class the reverse holds good. Greenfield recognises the lesions of the capsule as pericapsulitis or cellular infiltra- tion and tissue-formation occurring chiefly outside this structure, as hyaline thickening of the capsule itself, and as endo-capsulitis or the formation of concentric laminae of cells and tissue inside the capsule, between it and the glomerular tuft.* Greenfield regards the cells lining the capsule to be capable of originating this forma- tion. Now in acute glomerulitis it is undoubted that layers of epithelial cells are formed inside the capsule, derived from germination of its lining endothelium, and in chronic glomerulitis also concentric layers of cellular- like tissue are in many cases found, which seems so far to be a reduplication of the endothelial lining of the capsule. The appearances leave no doubt as to the derivation of this tissue from these cells, which are in reality epithelial cells. AVe are unable, therefore, to regard the formation as true connective tissue. On the other hand, one is struck with its general resemblance to the more superficial portion of the Malpighian layer of the epidermis. In the kidney formation, however, the cement substance between the cells is more abundant. It is in reality an epithelial form- ation, its lamellar disposition being largely due to pressure from within, i.e., exudation round the glomerular tuft. I wish, however, to note more particularly certain other changes which are found in connection with chronic glomerulitis. These are : 1. The epithelial cells covering the glomerular tuft proliferate, assuming a peg-top or columnar shape, and are desquamated into the peri- glomerular space, where they assume a rounded form. Afterwards they may enter into the formation of the concentric laminae of cells already alluded to. 2. The * New Sydenham Society’s Atlas of Pathology, Fascic. ii., 1879.