374 INANITION AND MALNUTRITION 



indicated that these renal lesions may be related to a true parenchymatous 

 nephritis. 



In 571 necropsies at the N. Y. Foundling Hospital, on children from new- 

 born to 5 years, Bovaird and Nicoll ('06) concluded that in general the kidney 

 weight varies directly with the body weight, although exceptions occur. 



Lucien ('08) concluded that in athrepsia the kidneys are congested; and 

 abundant deposits of urates usually color the infarcts in the tubules of Bellini 

 a bright orange-yellow. In a more detailed study of the renal lesions in athrep- 

 tic infants, Lucien ('08b) found the kidneys macroscopically normal in most 

 cases. Capillary congestion, glomerular sclerosis, and granulations in the 

 epithelium and lumen of the convoluted tubules and ascending limb of Henle's 

 loops were noted. The granulations are due to urate of soda, forming yellow 

 streaks (infarcts) in the tubes of Bellini. Tubular steatosis was not observed. 

 Lucien concluded that the athreptic renal lesions are not specific, but may 

 occur in all the infantile dystrophies. 



Helmholz ('09) studied the histological changes in 6 cases of pedatrophy. 

 "In den Nieren fand sich zumeist triibe Schwellung des Epithels, zweimal 

 Kolloid-degeneration, sonst aber lagen normale Verhaltnisse vor." 



Schelble ('10) incidentally observed the renal histology in 28 cases of pedat- 

 rophy, but noted no constant or characteristic changes. Monckeberg ('12) 

 described the general atrophic changes in the kidneys and other organs resulting 

 from malnutrition. 



Maillet ('13) in athreptic infants noted slight renal lesions, including cloudy 

 swelling or fatty degeneration in some convoluted tubules; occasionally pycnosis 

 and cytoplasmic atrophy in the intermediate segments, and slight sclerosis of 

 Henle's loops. 



Mattei ('14) recorded the weights of the kidneys in several athreptic infants. 

 He noted marked renal congestion and slight sclerosis of the glomeruli, but 

 concluded that in general the kidney presents no constant lesions of importance. 

 Lesage ('14) found a renal weight of 18 g. (normal 25 g.) in an atrophic 

 infant of 4 months. Lesage and Cleret ('14) in congenital spasmodic atrophy 

 of infants failed to find in the kidney the sclerosis which was characteristic in 

 most organs. 



Nobecourt ('16) reviewed the previous work on infantile atrophy, including 

 the renal lesions, which are usually comparatively slight. The true paren- 

 chymatous nephritis sometimes found is ascribed to complications. 



Marfan ('21) stated that in athreptic infants the weight of the kidneys 

 appears variable, either normal or decreased. In infants dying before the end 

 of the first month, the deposits of urate of soda (considered by Virchow as 

 normal in the newborn) in the tubules of Bellini, calices, etc. are frequent and 

 characteristic of malnutrition. 



In famine-stricken children of various ages, Nicolaeff ('23) found the kidneys 

 less atrophic than the liver, sometimes appearing normal, sometimes hyperemic. 

 In hydremic, edematous subjects, the kidney on section may be pale. The 

 renal epithelial cells appear swollen, with indistinct contours and small Mal- 

 pighian glomeruli. The urine in these cases is not albuminous. 



