712 



SOFTENING AND INDURATION. 



equal in degree throughout the whole organ ; 

 frequently, certain spots, the seat of old effu- 

 sions of blood, are denser than the indurated 

 tissue around them ; and eccymoses and dark 

 yellow and black spots, are found sometimes 

 scattered over the hardened tissue. This 

 variety of induration may be accompanied by 

 increase or decrease of bulk, or no alteration 

 in size may occur ; in degree, it may vary 

 from the slightest increase of consistence, de- 

 pending upon excessive nutrition, to a bony 

 hardness. 



Softening of the kidney is of common occur- 

 rence, being frequently found, with an enlarged 

 state of the organ, in several of the diseases 

 comprehended under the term Bright' s disease. 

 It exists also in the kidneys of diabetic sub- 

 jects, and in some cases* of renal calculi. 

 When produced by inflammatory action, the 

 softened kidney is dark red, and when a con- 

 sequence of a perverted state of the nutrition 

 of the organ, it is usually of a pale colour. Ge- 

 nerally speaking, the softened state is produced 

 by enlargement of the uriniferous tubes, and a 

 consequent diminution of the solid matrix, or 

 this last only may be affected ; and when such 

 is the case, the tissue breaks down with the 

 slightest pressure. In degree, softening may 

 vary from simple flabbiness to a state ap- 

 proaching diffluence. 



Induration of the kidney is generally found 

 with an atrophied state of the organ ; it is a 

 sequel of acute, and is found in chronic, ne- 

 phritis, especially in gouty subjects. In these 

 the kidney is frequently indurated, paler than 

 natural, less vascular, and many of its tubes 

 may be blocked up with urate of soda. In- 

 duration is sometimes accompanied by an 

 hypertrophied and a darkened state of the 

 organ. In the first stage of induration, the 

 consistence of the organ is slightly exagge- 

 rated, and the finger makes no impression on 

 it ; in such kidneys we find superficial star- 

 like venous twigs, and more or less confusion 

 of the cortical tissue. In a more advanced 

 stage, the tissue may become nearly as hard 

 as cartilage, and perfectly colourless. Por- 

 tions only of the kidney may be affected, but, 

 generally, the greater part of it suffers ; and 

 it is, comparatively speaking, rare to find car- 

 tilaginous induration of one or more of the 

 mammilated processes. 



Induration and softening of the uterus are 

 frequently products of acute inflammation of 

 the organ ; the first is formed but slowly, 

 the latter with great rapidity, and may or 

 may not be complicated with effusion and in- 

 filtration of pus, into the muscular structure. 

 Uncomplicated softening is frequently the re- 

 sult of a more chronic and subacute inflam- 

 matory action, and is occasionally found in 

 the impregnated uterus, being made known to 

 the practitioner by the spontaneous rupture 

 of its walls, and the passage of its contents 

 into the cavity of the abdomen. A soften- 

 ing, either general or partial, is found in 

 cases where there were no uterine symptoms 

 during life; the tissue is as friable as that 

 of a softened spleen ; but none of the pro- 



ducts of inflammation are to be found. It 

 is, probably, produced by a perverted and 

 defective state of the general nutrition ; the 

 uterus, from its low vitality, prominently suf- 

 fering. A putrid sloughy-looking softening 

 occurs around growths and ulcerations of the 

 uterine tissue. 



Softening and induration of the ovaries are 

 usually produced by acute or chronic inflam- 

 matory action : the one, if found in the early 

 stages of ovaritis, is produced by the effusion 

 of serum into the tissue of the ovary ; and the 

 other, a sequel of the same disease, is pro- 

 duced by the contraction and hardening of 

 effused lymph. 



In old age, thickening of the fibrous coat, 

 and atrophy, and induration of the stroma, 

 with special hardening around old Graafian 

 vesicles, are very common : this state is fre- 

 quently preceded by a flabby consistence of 

 the organ. 



In the puerperal state, the ovaries are sub- 

 ject to complete softening and disorganiza- 

 tion ; the natural structure is lost, and, in 

 its place, is a pulpy diffluent bloody-looking 

 mass. 



An indurated state of the prostate gland 

 is common enough in old age, and is gene- 

 rally accompanied by hypertrophy ; and a grey 

 or white hardening of the testicle and epidi- 

 dymis, with or without destruction of the 

 seminiferous tubes, is frequently found as a 

 sequel of chronic inflammation. 



A softened state of the whole or part of 

 the osseous framework of the body, is met 

 with in scrofulous habits, and in persons suf- 

 fering from cancerous cachexia, under the 

 form of rachitis and mollities ossium. In 

 the first of these diseases, there is a deficient 

 deposit of earthy matter, and the animal matter 

 is probably of an unhealthy quality ; whilst 

 in the second, the constituents are not defi- 

 cient in quantity, but bad in quality, and the 

 vital properties of the bone are completely 

 deranged ; the osseous structure has lost its co- 

 hesive power, and breaks with the least mus- 

 cular effort. In rachitis, the bones may be bent 

 in any direction, and are easily cut ; their cen- 

 tre resembling cartilage. In mollities ossium, 

 the knife penetrates the tissue, which appears 

 to consist of numerous cells, with thin walls, 

 and containing an oleaginous fluid, with the 

 greatest ease. Occasionally, bones are found 

 so softened as to resemble lard in consistence ; 

 and sometimes in subjects which have suffered 

 from chronic disease, the ribs are more easily 

 cut through than the cartilages. In caries, 

 also, there is a softening and absorption of 

 the bony texture, which crumbles away on the 

 slightest touch. 



Softening of cartilage is found under three 

 forms. It may lose its usual elasticity and 

 become doughy, or the usually dry and elastic 

 cartilage of an adult may be found soft, as if 

 it were that of an infant ; it acquires extensi- 

 bility, and its elasticity diminishes. Finally, 

 the cartilage of adult life may so lose its con- 

 sistence, as to resemble embryonic cartilage ; 

 it becomes pale and transparent, its quantity 



