Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis.
- Pierre Charles Alexandre Louis
- Date:
- 1844
Licence: Public Domain Mark
Credit: Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
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![Another anatomical change, much rarer even than renal tu- bercles, in phthisis, is fatty transformation of the kidneys. In two hundred and fourteen cases observed by myself, I ascertained the existence of this transformation once,—in a male, aged sixty, who died at the Hospital of La Pitie, after five months' illness. There had been no symptoms, apparently at least, furnished by the urinary organs; but, on examination after death, I found the left kidney closely adherent to the psoas parvus and the spleen, and transformed into a fatty mass, larger by a third than the right kidney. The transformation affected the entire organ, except a portion, two Hues [4 millimeters] thick, and from two inches and four lines to two inches and nine hues [6 to 7 centimeters] in superficial extent, where the natural characters of the renal tissue were retained. The calices ex- isted still, and were easily to be recognized; whereas the pelvis had disappeared, having been transformed, with the entire of the ureter, into a solid cord. The fatty tissue in several places retained the form of the tubular cones; and at their circum- ference, at a certain distance from their apex, appeared laminae, having the aspect of cellular tissue, and rendered distinct by their shining blueish colour. Each of the cones of fatty sub- stance was pretty easily broken down with the finger, in about the same manner as a softened kidney. Although this is the only instance of the kind which has presented itself to my observation, it deserves attentive consi- deration, inasmuch as it supplies a new proof of the tendency of the viscera to undergo fatty transformation in phthisis. I have carefully examined the kidneys of nearly five hundred subjects cut ofl by all varieties of disease, without discovering the smallest particle of tuberculous or fatty matter. However, an able observer, M. Rayer, states in the work already referred to, that although rarely, still he has met with tubercles in the kidneys, when none existed in the lungs. I have in vain searched for an instance of the fact in M. Rayer's work. There is, no doubt, a case of renal tubercles, in which the individual presenting them had only two gray semi-transparent granulations in the lungs: but this case does not constitute an exception; and it is a question whether the few instances to which M. Rayer refers have escaped me. Besides, in these cases the other morbid appearances](https://iiif.wellcomecollection.org/image/b21513235_0152.jp2/full/800%2C/0/default.jpg)
