Anatomical Changes. 991 



due to nutritive disturbances and leads to cloudy swelling and necrosis 

 of these cells. The kidneys are enlarged only slightly or not at all, 

 fairly firm or slightly softened, their capsule is easily peeled off, the 

 configuration of the cut surface looks washed out, while the glomeruli, 

 overdistended by blood, stand out clearly in the form of red dots; 

 the cortical substance is grayish-red, perhaps traversed by grayish- 

 yellow spots and stripes; the medullary substance is colored intensely 

 red; the tissue is sometimes moist with serous fluid, and turbid fluid 

 which contains uninjured and degenerated epithelial cells, detritus, 

 threads of fibrin, and perhaps white and red blood corpuscles may be 

 scraped from the cut surface. In many cases the disease is most 

 marked in the glomeruli (Glomerulonephritis) ; while in others the 

 tubuli uriniferi appear to be involved more severely (Tubulonephritis). 

 Sometimes, most markedly in swine erysipelas, numerous small 

 hemorrhages are found especially in the cortical substance (N. par. 

 haemorrhagica). 



Microscopical findings: The blood vessels are filled; fibrinous exudation, 

 perhaps slight cellular infiltration between the tubuli uriniferi and fibrinous exuda- 

 tion in the capsules of Bowman, the epithelial cells being granular, swollen, partly 

 degenerated and in process of breaking up; the tubuli contain hyaline and epithelial 

 casts. 



Nephritis Acuta Diffusa. The kidneys are decidedly enlarged, 

 soft and frialile, the capsule is soft, easily peeled off from the moist 

 and glistening surface, the cortical substance is also moist throughout, 

 very broad ; the gray cut surface shows numerous yellow spots and 

 streaks, often small or (especially in swine plague) large hemorrhages, 

 a large amount of a thickish fluid may be scraped off from the cut 

 surface (large, mottled kidney). 



Microscopical findings: The blood vessels are distended; interstitial hemor- 

 rhages; leucocytes and epithelial casts in the tubuli uriniferi; cellular and serous 

 infiltration of the connective tissue; degenerative processes in the epithelial cells, 

 exudation in the capsules of Bowman. 



According to Oagny and Nocard the epithelial cells of the convoluted and 

 straight tubuli disintegrate even in previously healthy kidneys during a prolonged 

 severe attack of parenchymatous or even fatty degeneration and become loosened 

 on the walls of the tubuli. In consequence a chyluslike liquid which looks like pus 

 is, on pressure upon the kidneys, discharged from the tubuli uriniferi; it contains 

 numerous epithelial cells and free fat globules. A similar liquid is found also in 

 the renal pelvis and in the upper portions of the ureters. 



In cases of severe acute nephritis post-mortem examina- 

 tion usually reveals also dropsical changes in the body cavities 

 and in the subcutaneous connective tissue. 



Symptoms. Acute parenchymatous nephritis is the most 

 frequent form of acute renal inflammation and preferably 

 accompanies febrile acute infectious diseases (febrile albumin- 

 uria). It is accompanied by moderate albuminuria, the albu- 

 men of the urine usually amounting barely to 1-2%. The 

 quantity of urine is either normal — and this is more frequently 

 the case — or it is somewhat diminished, mostly in consequence 

 of the cardiac weakness produced by the basic disease; only 

 in exceptional cases is the amount of urine slightly increased. 

 The urine either furnishes no organic sediment or this consists 

 only of few renal epithelia, sometimes of hyaline, granular 

 or epithelial casts, also occasional red or white blood corpuscles. 



