20 MODE OF PRODUCTION 



the urine secreted could not be examined. Perhaps 

 the value of any conclusions drawn from these facts 

 is increased from the circumstance of M. Rayer and 

 Dr. Osborne having found fibrinous clots filling the 

 renal veins in those who had died in the acute stage, 

 an occurrence which shows that a very imperfect and 

 retarded, if not a completely obstructed, circulation 

 through those vessels had existed during life. 



The granular appearance of the exterior was also 

 more distinct in the congested kidney, arising from 

 the distension of the granules naturally existing 

 there. 



Such are the morbid appearances of the most 

 acute form when it has proved rapidly fatal ; but it 

 is a point of some importance to learn the nature of 

 the changes which take place in cases where the 

 patients are not so rapidly cut off by the disease. 



There is an interesting case of acute idiopathic 

 nephritis related by Mr. Snow, in a late number of 

 the American Journal of Medical Sciences: the 

 patient died at the end of nine days, the secretion 

 of urine during that time having been entirely 

 suppressed, and symptoms of poisoning from the 

 retention of urea in the blood having preceded 

 death. On examination, the left kidney was atro- 

 phied, and on inquiry it was ascertained, that several 

 years before she had an attack of some nephritic 

 disease, which, from the symptoms mentioned by IHT 

 friends, was probably of the same nature as that 

 which proved fatal. In the recently inflamed organ, 

 the cortical portion to about half its extent was 

 opaque, whitish, and seemed infiltrated with lymph, 



