DISEASES OF THE URINARY ORGANS. 



SECTION J. 

 DISEASES OF THE KIDNEY. 



OHAPTEK I. 



. HYPER^EMIA OF THE KIDNEY. 



HTPEE^EMIA of the kidney and its consequences are not to be con- 

 founded with inflammation of the kidney, although during life it is some- 

 times quite impossible to distinguish between the two, and notwith- 

 standing that similar symptoms appear in both disorders, such as the 

 presence of blood and albumen in the urine, as well as the appearance 

 in it of peculiar objects, generally called fibrinous casts (although it is 

 probable that they are not composed of fibrin, and certainly are not 

 pure fibrin, but consist in great part of mucin). 



ETIOLOGY. A thorough knowledge of the normal circulation of 

 the kidney is indispensable to a proper understanding, not only of the 

 physiology, pathogeny, and etiology, but also of the symptoms of hy- 

 peraemia of this organ. To Virchow the credit is due of having cor- 

 rected some of our former ideas upon this subject, and of having ren- 

 dered others more complete. 



According to the result of his researches, the branches oi one par- 

 ticular portion of the renal artery (that, namely, which belongs to the 

 middle and outer part of the cortical substance) go exclusively to 

 form the afferent vessels, and, entering the Malpighian capsules as 

 such, these divide to form the vessels of the glomeruli. Then, leaving 

 the Malpighian capsule as efferent vessels, they again break up into 

 branches, once more to reunite as renal veins. On the boundary be- 

 tween the cortical and pyramidal substances there is a sort of " neutral 

 ground." Here there are arteries from which branches arise, some 

 forming afferent vessels, glomeruli, and efferent vessels, with long off- 



