EFFECTS ON THE URINARY TRACT 385 



kidneys normal in autopsies on 45 cases. Lubarsch ('21) mentioned deposits of 

 hemosiderin in the epithelium of the kidney and other glands. Fracassi ('22), 

 however, observed albuminuria in cases of edema in war prisoners. In 2 

 cases, autopsy revealed marked increase in renal connective tissue, in some 

 places more or less completely replacing the glomeruli and tubules. The kid- 

 neys also showed necrosis and granular degeneration of the greater part of the 

 epithelium; a condition said to correspond to a (not entirely typical) chronic 

 interstitial nephritis. 



In pellagra, Fraenkel ('6o-'7o) reported the kidneys decreased in weight in 

 46 out of 52 autopsies. Lombroso ('92) stated that the kidneys are rarely nor- 

 mal, uremic conditions being common. He found the kidneys fatty in 21 cases; 

 atrophic and cirrhotic in 33; cystic in 5; and with uric acid calculi in 1. Tuczek 

 ('93) mentioned atrophic and fatty degeneration of the kidneys and other 

 organs. Marie ('08, '10) concluded that the kidneys are usually subnormal in 

 weight, often showing fatty degeneration of the parenchyma, with or without 

 interstitial sclerosis. Nicholls ('12) in 8 African cases found the kidneys averag- 

 ing only 3^ ounces each. Kozowsky ('12) in 16 cases found in the kidney con- 

 gestion, cloudy swelling, fatty degeneration, pigmentation, etc. Raubitschek 

 ('15) designated these degenerative changes in the kidney as "Nephritis pella- 

 grosa." The marked renal changes in pellagra were also reviewed by Harris 



d9). 



In human rickets, Wohlauer ('n) concluded that the kidneys are neither 

 structurally nor functionally disturbed, although certain characteristic urinary 

 changes occur. Jackson and Carleton ('23), however, found the weight of the 

 kidneys markedly (42-48 per cent) above normal in albino rats with experi- 

 mental rickets. The interpretation of this hypertrophy is somewhat doubtful, 

 however, since the rats on similar diets, but killed before the appearance of 

 rachitic symptoms, also had kidneys 33 per cent above normal weight (Table n). 



Vitamin Deficiencies. — In the kidneys of rats on diets low in vitamin A, 

 Davis and Outhouse ('21) found chiefly a cloudy swelling of the parenchyma 

 in the collecting tubules; more pronounced in the second generation. In some 

 places the cells of the tubules appeared "skeletonized" and the glomeruli 

 shrunken. Osborne and Mendel ('17c) and Mendel ('20) found urinary calculi 

 in the kidneys or bladder of 81 out of 857 albino rats on diets deficient in vitamin 

 A. Meyerstein ('22) noted renal changes in young white rats on diets deficient 

 in vitamins A and B. Beach ('23) described renal enlargement, with urate- 

 filled tubules, in chicks on diets deficient in vitamin A. Herter C97) found 

 renal enlargement, hemorrhagic spots and granular degeneration of the 

 secretory epithelium in pigs during fat starvation, probably involving deficiency 

 in vitamin A. 



In human beriberi (due to deficiency of vitamin B), Duerck ('08, '08a) 

 gave a review of the lesions, with weights of the kidneys (usually subnormal) 

 in 10 cases. Nephritis was not observed, but the kidneys were congested, 

 sometimes with small hemorrhages. Strong and Crowell ('12) found acute 

 parenchymatous degeneration of the kidney in the case studied. From 18 

 necropsies of infantile beriberi, Andrews ('12) concluded that the kidneys are 



