The histology of granular kidney [with plates V and VI] / by Robert Saundby.

Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: The histology of granular kidney [with plates V and VI] / by Robert Saundby. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    In the small red kidney he states that the disease commences in the vessels and glomeruli, the affection of the latter being fibrous trans- formation with adhesion of the capillary tuft to Bowman’s capsule, as a consequence of which, “ or of an associated inflammatory process f the tube wastes. “ In the larger form there is much more true interstitial growth or exudation.” The “ associated inflammatory process ” which Dr. Greenfield throws in, by the way as it were, to eke out his hypothesis, con- stitutes, in my opinion, the link which binds the whole together in one pathological series. The preparations from which the drawings illustrating the de- scriptions I am about to give, were taken from two cases, of which abstracts of the post-mortem appearances are subjoined: Case 1.—J. W—, male, set. 49. Ascites and oedema of lower limbs. Heart, 21 oz., valves competent, muscular fibre healthy. Liver weighed 54 oz., appeared healthy, but under microscope showed commencing cirrhosis (specimen shown). Spleen enlarged and rather hard. Kidneys together weighed 7 oz., small, lobulated, w ith many cysts on surfaces; capsules thickened and opaque; cortices about one line thick, dark coloured; cut surfaces showed open mouths of dilated vessels. Case 2.—M. H—, female, set. 50. Ascites and oedema of lower limbs. Arteries of pia mater thickened and pigmented. Heart weighed 9 oz. ; muscular fibre pigmented; valves healthy. Liver large, smooth, soft, yellow on section; old peritonitic ad- hesions compressed portal vein. Spleen small and dark coloured. Kidneys together weighed 7oz., surfaces granular and lobulate<l; capsules thickened and adherent; no cysts ; cortices only one line thick, I shall deal with the histological details in the following order: a, the convoluted tubes ; /3, the straight tubes; y, the Malpighian bodies ; S, the vessels; e, the connective tissue. a. The convoluted tubes.—The cortex of the wasting organ presents the convoluted tubes in varying degrees of destruction. The changes may be best considered as they involve—1, the epithelium; 2, the basement membrane. 1. The epithelium.—As already mentioned, the changes in the epithelium vary wuth the intensity of the inflammatory process. In the more acute cases the epithelium proliferates rapidly, and the tubules become filled with fattily-degenerated cells. This is too well known to need further remark, but it is not generally understood
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