778 



THE UEINAEY TRACT. 



I have often found the connective tissue, both in chronic catarrhal and 

 in chronic croupous nephritis, the seat of waxy degeneration, but, as before 

 stated, the highest degrees of this change are unquestionably observed in 

 chronic croupous nephritis. Simultaneously with the changes above 

 described, the walls of the blood-vessels in the connective tissue also under- 

 go waxy degeneration. I have occasionally seen specimens in which the 

 capillary coat was broadened and exhibited marked signs of waxy degenera- 

 tion, even before the arterial walls were affected. The more common occur- 

 rence, however, is for the middle coat of the artery to give the first indica- 

 tions of the invasion of this metamorphosis, a characteristic which is the 

 rule in waxy degeneration of the spleen. 



The tufts are also very frequently involved in the waxy metamorphosis, 

 and I have hardly seen a case of atrophy or cirrhosis without a waxy change 



FIG. 355. WAXY DEGENERATION OF THE KIDNEY IN CHRONIC 

 CROUPOUS NEPHRITIS; FORMATION OF A WAXY CAST. 



W, shining, waxy lumps in the caliber of the tubule ; L, epithelia and endothelia of the 

 tubule, partly in waxy change ; E, unchanged tubular epithelia; J, interstitial connective 

 tissue. Magnified 600 diameters. 



of the tufts more or less marked. The tuft may, at the same time,be con- 

 siderably enlarged, or it may show no increase in size. It is far more com- 

 mon, however, to find the tuft atrophied and solidified, the calibers of the 

 capillary vessels obliterated, when invaded by the waxy degeneration. 



I have occasionally noticed in the veins, clots which were composed of 

 highly refracting globules, some of which exceeded the size of red blood- 

 corpuscles, each showing a central depression, and suggesting the idea that 



