CHAPTER VII. 

 DISEASES OF THE URINARY ORGANS. 



THE KIDNEYS. 

 PASSIVE HYPER.EMIA. 



Passive hyperaemia occurs in conjunction with valvular disease 

 of the heart, and diseases of the lungs, which seriously impede 

 the circulation as fibroid phthisis and severe emphysema. 



The kidneys are generally enlarged in the earlier stages, 

 are firm and elastic ; the capsule, which is not adherent, may 

 readily be removed, exposing a smooth surface. On section, 

 the cortex is found to be congested and swollen ; the Mal- 

 pighian bodies may be enlarged and stand out prominently ; 

 the pyramids are deeply congested, and have a striated ap- 

 pearance, produced by dilatation of their bloodvessels. 



At a later stage, there may be a very considerable hyper- 

 plasia of interstitial connective tissue, and the organ conse- 

 quently more or less decreased in size and dense cyanotic 

 induration. 



Microscopically, the prominent features are the dilatation 

 and overfilling of the bloodvessels ; atrophy of the epithelium 

 of the tubules, and a marked increase in the amount of inter- 

 stitial connective tissue. Quite often there are small extrava- 

 sations of blood within the capsule of the Malpighian bodies. 



BRIGHT'S DISEASE 



To bilateral inflammations of the kidneys, in which the 

 irritant has gained access through the blood, the generic term 

 Bright's disease is applied, after the clinician who first ex- 

 plored this important field of pathology, and called attention 

 to the relation of certain structural changes in these organs 

 the inflammatory nature of which was later recognized to 

 albuminuria and general dropsy. 



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