442 THE SOLID^. 



Pathology. 



The kidney would appear to be more liable to morbid 

 alterations than any other organ in the body ; nevertheless, 

 its pathology is still far from being completely understood, 

 notwithstanding that several observers have paid especial at- 

 tention to the subject. Several of the pathological conditions 

 of this organ appear to have been confounded together under 

 the common term " Bright's Disease." 



A very frequent pathological condition of the secreting 

 cells of the kidney is that in which they are laden with glo- 

 bules of an oily fluid> similar to those which occur in the 

 hepatic cells in the affection commonly called fatty liver, or 

 fatty degeneration of the liver, but which would be more 

 correctly distinguished by the appellation of oily liver ; the 

 corresponding affection in the renal organ being known by 

 the name of oily kidney. 



It is this condition of the renal cells which, in Dr. George 

 Johnston's* opinion, constitutes the true Morbus Brightii. 



The large, smooth, and mottled kidneys are those in which 

 the oily matter abounds ; the smoothness, according to Dr. 

 Johnston, depending upon the uniform distribution of the 

 tubes in the cortical portion of the kidney with the oily 

 matter. 



The wasted and granular kidneys, according to the same 

 observer, are those in which the accumulation of fat takes 

 place less rapidly and less uniformly; certain of the convoluted 

 tubes becoming distended with fat, forming prominent granu- 

 lations ; and these, pressing upon the surrounding tubes and 

 vessels, occasion their obliteration and atrophy, a wasting and 

 contraction of the entire organ being the -result. This con- 

 dition attends the more advanced stages of Bright's Disease, 

 and is the sequence of the first described form of the affection. 



Dr. Johnston, from numerous examinations, has arrived at 



* On the Minute Anatomy and Pathology of Bright's Disease of the 

 Kidney, and on the relation of the Renal Disease, to those Diseases of the 

 Liver, Heart, and Arteries with which it is commonly associated. George 

 Johnston, M.D. Medico-chirurgical Transactions, 1846. 



