LESIONS IN ABDOMINAL CAVITY 145 



easier than does the healthy kidney. We also find that the organ 

 is very friable and crumbles up if squeezed firmly in the hand. The 

 cut surface of the kidney is bloody and drips a reddish-colored 

 fluid. If this is washed away, and we examine the cut surface of 

 the kidney, we find that it is markedly swollen and bulges, due to 

 the increased tension produced by the marked engorgement with 

 blood. When we examine the surface after thoroughly washing 

 away the blood we find that these same pin-point spots which were 

 noticeable on the outer surface are prominent here also in the outer 

 portion of the surface. 



Now, if the necessary laboratory facilities are at hand, and 

 sections for examination with the microscope be prepared, a very 

 beautiful appearance is shown under the microscopic lens. The 

 tissue shows very plainly the results of engorgement and degenera- 

 tive changes In the outer or cortical portion of the kidney we 

 find the small clumps of blood-vessels, known as the glomerulus, 

 very markedly engorged with blood and hemorrhagic. The tubules 

 are also swollen so much that the lumen or canal is entirely closed. 

 The individual lining cells are also greatly changed. They stain 

 very faintly and appear more Hke shadow cells under the micro- 

 scope. The nucleus of the cell is badly broken up, and the entire 

 picture shows the effects of severe changes produced by the 

 disease. 



In the canal of the tubules we find dead cells, clots of blood, 

 and casts of various kinds. Red and white blood-cells are com- 

 mon, and fibrinous plugs, due to hardening of the fibrinous exudate, 

 pour out from the overfilled vessels. , 



Changes in Bladder. — The urinary bladder will usually be 

 found to contain a large amount of urine. This urine is high 

 colored and usually has a cloudy and, not infrequently, a some- 

 what bloody appearance. The odor is also quite strong in the 

 majority of cases. If we cut into the bladder wall and allow the 

 urine to escape, and then turn the bladder walls inside out, we 

 find a very noticeable change in a great number of cases. Nor- 

 mally the inner wall of the bladder is a clear white or grayish color, 

 with no blood-vessels or red spots to be seen. In the organ taken 

 from cholera carcasses we usually find, especially in acute cases, the 

 spotting of the inner mucous lining with numerous small pin-point- 



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