380 INANITION AND MALNUTRITION 



" Zusammenfassend kann man feststellen, dass im Laufe der Verhungerung 

 die Leber- und Nierenzelle demselben Mechanismus folgend, schwere Verander- 

 ungen erleiden: Ein Teil derselben, namlich diejenigen, welche sich auf Kosten 

 des Zytoplasmas und in den ersten Stadien der Verhungerung bilden, ent- 

 sprechen in exacter Weise den Veranderungen,die durch verschiedene hypo- und 

 hypertonische NaCl-Losungen in denselben Elementen erzeugt werden. Die 

 anderen schweren Veranderungen dagegen, welche sich auf Kosten des Zyto- 

 plasmas wie des Kernes, und zwar nur in den letzten Verhungerungsstadien 

 bilden, entsprechen ganz genau den Strukturumanderungen, welche sich an 

 denselben Elementen im Laufe der aseptischen Autolyse einstellen." 



Stefani '0 10 ) found that while in normal dogs subjected to starvation the 

 kidneys lose 25-30 per cent in weight, if one kidney is removed at the beginning 

 the remaining kidney appears nearly normal in weight at the end of inanition. 

 Thus the tendency to atrophy during inanition is counterbalanced by the ten- 

 dency to compensatory hypertrophy (contrary to Sacerdotti '94). 



In several dogs and a fox which died from protracted inanition, Morgulis, 

 Howe and Hawk ('15) found the kidneys with variable form and extent of 

 degeneration. Bowman's capsule was invariably thickened, "as in the case of 

 nephritic kidneys." The cells of the convoluted tubules appeared coarsely 

 granular and always vacuolated. Vacuolation of cells was rare in Henle's loop. 

 The nuclei appeared small and irregular. Casts (cellular and hyalin) were 

 frequent. The cells of the collecting tubules were nearly normal. 



In the kidney of starved guinea pigs, Rondoni and Montagnani ('15) 

 observed slight congestion, rarely cortical hemorrhages. Sometimes the nuclei 

 of the glomerular layer of Bowman's capsule and of the glomerular endothelium 

 appeared deformed and pycnotic. In some cases the entire cortex was edema- 

 tous, with granular coagulum in the spaces between the tubules. 



In white rats which had lost nearly 50 per cent in body weight by starvation, 

 Sundwall f'17) noted extreme congestion of all vessels, both glomerular and 

 intertubular capillaries, with albuminous degeneration of the cells of the urinary 

 tubules. 



Jackson ('15) in adult albino rats on acute inanition (water only) with 

 average loss of 7,1, per cent in body weight, or on chronic inanition (underfeeding) 

 with loss of 36 per cent in body weight, found a loss of 26 or 27 per cent in the 

 weight of the kidneys (Table 4). In younger rats the loss was still less, and on 

 those held at constant body weight by underfeeding from 3 to 10 weeks of age 

 there was even a slight increase (4 per cent) in the average kidney weight. 



In still younger albino rats, underfed from birth to 3 or 10 weeks of age, 

 Stewart ('18) found the kidneys 21-38 per cent above normal in weight; and 

 in a later study ('19) in rats held at birth weight for 16 days by underfeeding 

 the kidneys showed a markedly persistent growth, increasing 90 per cent in 

 weight. In the stunted offspring of albino rats severely underfed during preg- 

 nancy, Barry ('20, '21) found the kidneys only 6 per cent above normal weight 

 (Table 4). 



In albino rats ref ed after underfeeding (at maintenance) from 3 to 1 2 weeks 

 of age, Stewart ('16) found the kidneys nearly normal in proportion to the body 



