136 



Malpighian bodies. His material included the following diseases : Nephri- 

 tis, after cold, parturition, scarlatina, diptheria, measles, croup, pneumonia, 

 typhoid, erysipelas, puerperal fever, endocarditis ulcerosa, malaria maligna, 

 constitutional syphilis, tuberculosis, eclampsia, atrophia infantum, 

 encephalitis neonatorum, cholera nostras, epidemic meningitis, empyema 

 without tuberculosis, carcinoma, pernicious anemia, leukemia, sunstroke, 

 and chlorate of potash-phosphorus-lead and arsenic poisoning. In none 

 of these affections did he ever find a hyaline fibrin thrombosis of the 

 glomerular vessels; in fact, he does not mention it, though he speaks 

 of amyloid degeneration. Posner is probably the first writer specifically 

 to mention the presence of typical fibrin in the kidneys, however, not 

 in the glomeruli but in the interior of the tube casts, found in the kidneys 

 of rabbits after the ligation of the renal artery. Israel observed retieula 

 of fibrin in the convoluted tubules, and solid fibrin masses in the cap- 

 sular space of the glomeruli in experimental anemic necrosis induced 

 bv ligation of the renal arterv. He evidentlv did not see fibrin thrombi 

 in the glomerular capillaries, because no mention is made of such an 

 occurrence. Engel reports the observation of five cases of chronic nephri- 

 tis accompanied by glomerulitis with the presence of fibrin threads in the 

 capsular space. These threads gave a positive Weigert's staining reac- 

 tion. Nothing, however, is said about the presence of fibrin in the 

 glomerular capillaries, Kahlden describes a case of post-scarlatinal 

 nephritis with complete anuria, in which he observed an obliteration of 

 the glomerular capillaries by a fibrillar and granular material which 

 he considered to be typical fibrin. The glomerular fibrin thrombi were 

 continued into the vasa afferent ia and efferentia ,and frequently beyond 

 these into the arteriola recta. However, Kahlden was not successful in 

 staining the thrombi satisfactorily by Weigert's method, as his tissues 

 had all been fixed in Flemming and in Mueller's fluids. Friedlaender, 

 according to the preceding writer, previously described a type of post- 

 scarlatinal glomerulo-nephritis wliich manifests itself from three to four 

 weeks after scarlatina and which is characterized by oedema, albuminuria, 

 oliguria, or even anuria. The microscopic examination of the kidneys 

 in such cases shows glomerular capillaries changed into solid, sausage- 

 like masses, making it scarcely possible to difl'erentiate the wall of the 

 capillary from its contents. Whether Friedlaender looked upon this 

 thrombotic material as fibrin does not appear. Ernst found fibrin in the 

 capsular space of the glomeruli and also in the interior of the hyaline 

 tube casts in cases of nephritis. No mention is made of fibrin thrombi 

 in the glomerular vessels. Eibbert, speaking of glomerulo-nephritis in 

 one place and hyaline thrombosis in another, mentions hyaline fibrin 

 thrombi as occurring occasionally in the glomerular capillaries. Tschis- 

 towitsch, one of the most recent writers on obliteration and hyaline 

 degeneration of the glomeruli, does not mention hyaline fibrin thrombosis. 



From a review of the literature on the subject of glomerular 

 clianges in nephritis it would certainly appear that hyaline fibrin 

 thrombosis of the glomerular capillaries is a rather rare occur- 



