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lar capillaries. These capillaries may be entirely or partly occluded 

 by genuine fibrin thrombi, which give Weigert's staining reaction. 

 The thrombi are either solid or hollow tubular wall thrombi. 

 Where they are found, it can generally be shown that they extend 

 into the afferent and efferent vessels and beyond these into the inter- 

 tubular ones. A careful study of the vessels fails to show any appie- 

 ciable morphologic change of their walls. The vascular endothelium 

 generally appears intact; occasionally some of the lining endo- 

 thelium may be missing, but this is certainly not general, but rather 

 exceptional. The fibrin thrombi are evidently formed independently 

 of the presence of plague bacilli in the kidneys; because in most 

 of the cases where we did encounter them in our material a very 

 careful search for these organisms in sections failed to reveal them. 

 However, in one case in particular there was a simultaneous occur- 

 rence of hyaline thrombi and bacillary emboli. In some places 

 the bacilli were actually located between the vessel wall and the 

 thrombus. However, since this was seen only in one case, it is 

 very clear that it was merely a coincidence; a causal nexus between 

 the bacilli and the thrombi did not exist. The very characteristic 

 hyaline fibrin thrombosis of the glomerular capillaries does not 

 appear to be found frequently in acute infectious diseases in which 

 the kidneys are greatly involved, nor, in fact, in any fomi of acute 

 or chronic nephritis. 



Welch, however, appears to consider it as not at all an uncommon 

 occurrence, and makes the following statement in regard to it : "Capillary 

 hyaline thromboses are common in the lungs in pneumonia, and in 

 hemorrhagic infarcts. In general infective and toxic states they may be 

 present in the liver, the lungs, and above all, in the kidneys. ^ The most 

 striking example of this form of thrombosis with which I am acquainted 

 is encountered in renal capillaries, chiefly of the glomeruli of swine 

 •dead of hog cholera; or of animals infected with the hog cholera bacillus. 

 In extreme cases there is complete anuria, and it may be impossible to 

 force more than a minimal amount of injecting fluid into the renal 

 vessels. Section stained with Weigert's fibrin sta^n look as if the capil- 

 laries had been injected with Berlin blue. Ribbert found similar hyaline 

 thrombi in the kidneys of rabbits inoculated with 8. Pyogenes aureus. 

 I have repeatedly found them in various experimental infections and 

 in human infections. They occur in eclampsia. Bacteria are not neces- 

 sarily present, so that toxines are probably the underlying causative factor, 

 and for this there is experimental evidence." 



It must be borne in mind that the term "hyaline thrombosis of the 



^ Italics our own ; not in the original. 



