770 



THE URINARY TRACT. 



After passing through these changes the tuft is reduced to a half or a third 

 of its original size. The capillaries remain only as radiating strings, and 

 these, with the altered capsule, admit the diagnosis of an atrophied and 

 solidified tuft, which is often found to be in waxy degeneration. Sometimes 

 around the atrophied tuft, consisting of a solid mass of connective tissue, a 

 light space is observed, traversed by delicate fibers and remnants of the 

 epithelia of the tuft and ,the capsule. This is a newly formed, probably 

 myxomatous basis-substance, which is produced by medullary corpuscles, the 

 offspring of the glomerular epithelia. (See Fig. 348.) 



In a more acute course of the disease, the tuft, together with the capsule 

 and all the surrounding tissues, including interstitial connective tissue, blood- 

 vessels, and convoluted tubules, break down into a mass of inflammatory 

 corpuscles, resulting in an extensive new formation of connective tissue, or a 



FIG. 348. CIRRHOSIS OP THE KIDNEY. ATROPHIED TUFT. 



T, tuft, transformed iu to fibrous connective tissue; R, remnants of epithelia of the tuft; 

 S, structureless, newly formed basis-substance ; E, remnants of epithelia of the capsule ; 

 C, considerably thickened capsule. Magnified 500 diameters. 



formation of cysts. Apparently an already atrophied tuft may in an acute 

 recurrence of nephritis break down into inflammatory corpuscles, and at last 

 disappear entirely. From this description it is evident that the term " glom- 

 erulo-nephritis," introduced by Klebs, is superfluous, for the inflammatory 

 changes of the tuft are invariably connected with general nephritis. 



I have also made examination of the changes which, in chronic catarrhal 

 nephritis, take place in the arterial coats, and which result in the destruction 

 of even large arterial vessels. (See Fig. 349.) 



The first thing noticed is that the lining endothelia of the artery are en- 

 larged and coarsely granular, and that a proliferation of inflammatory corpus- 



