An investigation into the microscopic anatomy of interstitial nephritis / by Bryan Charles Waller.

Date:
[1881]
Catalogue details

Licence: Public Domain Mark

Credit: An investigation into the microscopic anatomy of interstitial nephritis / by Bryan Charles Waller. 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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    from the presence of the superficial vessels, which run in these vallecula!. (See Coloiu-ed Plate, DicJcinson on Albuminuria ; see also BrigMs Reports of Medical Gases, 1827, vol. i.. Plates i.-iii.) Cysts are often seen on the surface. The consistence is tough and leathery, somewhat like caoutchouc. On section, the cortex is observed to be tough and diminished in size, being in extreme cases reduced to not more than two or tlaree lines in thickness; its colour is pale yellowish, uniform or mottled with red. The convoluted tubides and Malpighian capsides are frequently dilated into cysts. (See Plate vii.) These are sometimes very numerous, some being visible to the naked eye, while others are microscopic. The Malpighian bodies are smaU and atrophied, and so approximated by the general shrinking as to appear abnormally numerous. The medullary substance is generally but little altered, though occasionally cystic; the pyramids are sometimes hyperfemic, sometimes pale yellowish Like the cortex. (J).) Microscopic Ai^ioearances.—The cell-infiltration of the preceding stage is now in process of differentiation into fibrous tissue. Many of the cells are seen elongating and assuming a spindle shape; and the spindles, in their turn, are here and there undergoing metamorphosis into fully-formed fibrous tissue. True wavy fibrous tissue is most abundant in the spurious adventitia of the vessels,'and around the Mal- pighian capsides and convoluted tubules; that is to say, the increase is most marked in those situations where fibrous tissue normally exists. The Malpighian capsules are greatly thickened, leading to compression of the vessels of the glomerulus. In this stage, the smaU-cell formation is very distinct. Its elongation into spindles is perhaps best seen in logwood preparations, as this reagent stains the cells more deeply than carmine; and while inferior for general purposes, affords a somewhat readier demonstration of this particular fact. The importance of the fusiform change in the shape of the infiltrated round-ceUs is very great, as it affords one of the strongest arguments against Dr Johnson's theory of their origin from epithelial debris. The dispute as to the nature of the new tissue is to all intents and purposes settled by the fact of the cells assuming this fusiform shape ; for it is thus seen that they are in a stage, not of regression, but of growth; not of disintegration and decay, but of progression and differentiation. The arterioles of the kidney also present many noteworthy
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