ABSCESS OF THE KIDNEYS 187 



Pathological Anatomy. — A kidney thoroughly affected with amjdoid 

 disease is slightly enlarged, hard, smooth, and shows at the intersections a 

 deep yellowish-white coloration, easily distinguished on section. The 

 glomeruli are easily distinguished with the naked eye as small glossy spots. 

 On staining with Lugol's solution the affected parts are colored a mahog- 

 any-brown and with methyl are colored purple-red. For further details 

 see works on pathological anatomy. 



Clinical Symptoms. — The extremities are dropsical, with complete 

 loss of appetite, coma, uraemia, and then death. In a case where the ani- 

 mal was unsteady and weak, with paleness of the mucous membrane, Zim- 

 merman found an amyloid kidney associated with hypertrophy of the 

 left side of the cord. 



Therapeutics. — The treatment consists in following what is prescribed 

 in nephritis. 



Abscess of the Kidneys. 



(Suppurative Nephritis; Pyelonephritis.) 



Etiology. — The direct cause of the formation of abscess of the kidney 

 is direct injury of the kidneys or in the region of them, causing the forma- 

 tion of purulent abscess in the urinary passages, the bladder, the urethra, 

 or the pelvis of the kidney. In certain cases this condition is associated 

 with ulcerous endocarditis, from the results of an embolus which may be 

 liberated and get into the circulation. 



Pathological Anatomy. — Purulent nephritis occurs in various forms, 

 according to its origin. When this condition is caused by an embolus it is 

 seen in the shape of small abscesses which are easily distinguished by the 

 naked eye. When a section is made through the kidney, these abscesses 

 extending along the canaliculi present a peculiar appearance and are 

 grayish-yellow in color, round or oblong in shape, and are generally sur- 

 rounded by a red circle. When the spot is examined under the micro- 

 scope there are swarms of micrococci in the centre of the mass, and it is 

 reasonable to believe that these are the causes of the abscesses. Only in 

 rare cases do the abscesses become confluent, and when they do they form 

 large pus centres that, as a rule, cause death. When the abscess forms in 

 the pelvis of the kidney the pus extends into the straight urinary canals, 

 in some cases as far as the surface of the kidney, and is indicated by a pro- 

 trusion or elevation of the external surface, which is yellowish in the cen- 

 tre and surrounded by a circle of yellowish points. When large abscesses 

 are formed from these and become confluent, the whole kidney may 

 become altered into one large abscess. The covering capsule of the kidney 

 then becomes thickened and holds the abscess with its contents (pyo- 



