REN. 



261 



transparent appearance of the tubes, which in 

 the human kidney is the result of disease, 

 may constantly be seen in the kidneys of some 

 of the smaller animals ; as, for example, 

 those of a mouse or a young rabbit. On 

 examining thin sections of the kidneys of 

 these animals it will be found that the delicate 

 and semitransparent tubes, embedded in the 

 surrounding fibrous network, constantly pre- 

 sent more or less of the cyst-like appearance 

 represented in fig. 171. It can scarcely be 

 supposed that these appearances in the kidney 

 of the mouse indicate the existence of isolated 

 cells. In short, Mr. Simon's theory of renal 

 cysts is so opposed to all analogy, and so en- 

 tirely unsupported by facts, that it appears 

 needless to occupy the time of our readers by 

 a further detail of facts and arguments in 

 opposition to it. 



Renal Haemorrhage. Under this head I 

 will allude in a few words to a condition of 

 kidney which I have never had an opportu- 

 tunity of examining in the dead subject, but 

 the nature of which is sufficiently manifested 

 by the symptoms, and particularly by the con- 

 dition of the urine, as ascertained by a micro- 

 scopical examination during life. It is well 

 known that great irritation of the urinary 

 organs is a frequent consequence of the inter- 

 nal administration of oil of turpentine, or the 

 application of cantharides to the cutaneous 

 surface. The urine in these cases is generally 

 bloody, and is passed very frequently and in 

 small quantities ; there is great pain and irri- 

 tation about the kidneys and bladder ; but 

 there are no symptoms of suppression of 

 urine, such as drowsiness and tendency to in- 

 flammation of internal organs, symptoms which 

 are present, in a greater or less degree, in all 

 cases of " desquamative nephritis." In the 

 last-mentioned cases the epithelial lining of 

 the urinary tubes is the seat of disease, and 

 the imperfect elimination of the solid consti- 

 tuents of the urine is a necessary consequence 

 of the pathological changes which the secret- 

 ing epithelium undergoes. In the condition 

 of kidney now under consideration the Mal- 

 pighian capillaries appear to be the only parts 

 of the organ primarily affected. The irrita- 

 tion produced by the turpentine or the can- 

 tharides leads to engorgement of the Malpig- 

 hian tufts, which commonly ends in rupture 

 of the vessels, haemorrhage into the tubes, 

 and so the admixture of blood with the urine. 

 On a microscopical examination of the urine 

 fibrinous moulds of the tubes may be seen in 

 great numbers (Jig. 175), blood corpuscles 

 are entangled in the fibrine, but no epithelium 

 is found combined with them. The inference 

 is, that the epithelial lining of the urinary 

 tubules is unaffected, and this conclusion is 

 further supported by the fact already men- 

 tioned, viz., the absence of the usual symp- 

 toms resulting from a deficient excretion of 

 urea and the other solid constituents of the 

 urine. I have never seen a fatal case of 

 strangury ; but when haemorrhage from the 

 Malpighian capillaries has occurred in con- 

 nection with other pathological conditions 



which have terminated fatally, hsemorrhagic 

 spots are seen scattered over the surface and 

 through the cortical substance of the kidney. 



Fis. 175. 



Fibrinous moulds of the urinary tubules from the 

 urine of a patient who had strangury after taking 

 oil of turpentine. Some blood corpuscles are entan- 

 gled in the fibrine, as well as some octohedral crys- 

 tals of oxalate of lime which the patient was ex- 

 creting at the time the haemorrhage occurred. It is 

 important to observe that in this form of fibrinous 

 mould there is no epithelium from the tubes. Mag- 

 nified 200 diameters. 



These spots, when submitted to a microsco- 

 pical examination, are found to be composed of 

 convoluted tubes filled with blood which has 

 escaped from the Malpighian capillaries, and 

 after filling the capsule has passed into the 

 tube (fg. 176). This fact was first pointed 

 out by Mr. Bowman. 



Fig. 176. 



Malpighian capsule and portions of the urinary 

 tubes containing blood which has escaped from the 

 Malpighian capillaries. Magnified 200 diameters. 

 See also Jig. 149 d. 



The condition of kidney to which turpen- 

 tine and cantharides give rise may result from 



s 3 



