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glomerular capillaries" is freqiiently very loosely used by authors who 

 have written on changes of the kidneys in infections and it generally 

 refers to an ordinarj' hyaline degeneration and not to a true hyaline 

 thrombosis. In fact, a very careful study of the literature impresses one 

 with the conviction that the latter is very rare. It has been mentioned 

 with some emphasis in connection with only one renal affection, namely, 

 late post-scarlatinal nephritis. Our attention was first called by Klebs 

 to the changes in the glomeruli in diseases of the kidneys who introduced 

 the term glomerulo-nephritis and who stimulated further research into 

 this histo-pathologic change. He states that after scarlatina, the kidneys 

 are found either slightly or not at all enlarged and very rich in blood, 

 and the glomeruli appear as small, whitish points, which in sections are 

 seen to contain little blood and are darker and more cloudy than the 

 uriniferous tubules. However, neither Klebs nor Langhans, who studied 

 kidneys with glomerular lesions in twelve cases of scarlatina, say anything 

 about hyaline fibrin thrombi in the glomerular capillaries. The latter 

 states expressly that the fibrin cylinders in the tubules are composed of 

 a hyaline material which is not identical with fibrin. Boehm, Goemans, 

 Fichera, and Scafiddi ' have recently published contributions to the patho- 

 logic histology of the glomerulus, but they have not seen any fibrin 

 thrombosis of the glomerular vessels. The last two authors describe 

 hyaline degenerations of the glomerular capillaries and state that in the 

 kidneys, with changes in the glomeruli in the kidneys, there frequently 

 occur affections of the capillaries. The process begins in some loops, 

 which become glass like and transparent and take certain stains homo- 

 geneously. The process then spreads to several which become fused and 

 so form a homogeneous mass poor in nuclei. The few nuclei left show 

 profound disturbances, such as karyolisis or karyorrhexis. In still more 

 advanced cases one sees, in place of the glomerulus, a body smaller than 

 the smallest glomerulus, which is globular and bounded by a capsular 

 membrane. The body itself consists of a homogeneous, transparent, 

 uniformly stained, hyaline mass, which shows no capillaries at all or 

 only traces of them, and in which no more capsular space can be recognized. 

 Nuclei, if present at all, are either small or poorly stained, shrunken, 

 pyknotic, or fragmented. The cause of the necrosis and hyaline degenera- 

 tion of the glomerular capillares may probably be attributed in this 

 case, as in others to profound disturbances of nutrition of the vessel 

 walls and to obliteration of the capillaries which prevents the blood 

 circulation. Fichera and Scafiddi expressly mention that the process 

 described is different from true capillary thrombosis as it has been observed 

 in post-scarlatinal nephritis. Pearce investigated the histopathology of 

 the kidney in twenty-three cases of scarlatina, but did not find glomerular 

 thrombosis in any of them. Hansemann microscopically examined the 

 kidneys in 120 cases with special reference to the changes found in the 



. ^ Fichera and Scafiddi's quite exhaustive study contains a complete list 

 of the literature and quotes 110 articles on the normal and pathologic 

 histology of the glomerulus. 



