CLOUDY SWELLING. 335 



in ordinary life is assigned to inflammation. A number 

 of inflammatory processes on their first appearance really 

 exhibit nothing more than an increased assumption of 

 material into the interior of the cells, entirely resembling 

 what we find in simple hypertrophy. If, for example, 

 we consider the history of Bright's disease in its ordinary 

 course, we constantly find, that the very first thing which 

 can be detected in a kidney affected with this disease, 

 consists in this, that in the interior of the uriniferous tu- 

 bules whilst still quite intact, the individual epithelial 

 cells which are, as is well known, even in their normal 

 state tolerably large, become still larger. These epithe- 

 lial cells which fill up the tubules are not only large, but 

 at the same time also present a very 

 cloudy appearance, inasmuch as a larger 

 quantity of material than usual has 

 everywhere been taken up into the cells. 

 The entire uriniferous tubule is thereby 

 rendered broader, and appears even to 

 the naked eye as a convoluted, whitish, 

 opaque body. If we isolate the indi- 

 vidual cells, which is somewhat difficult, 

 as the cohesion of the particles compos- 

 ing them has usually begun to suffer, we find in them a 

 granular mass apparently containing nothing else than 

 the granules which are normally present in the interior 

 of the cells, but which accumulate in greater numbers the 

 greater the energy with which the process is carried on, 

 so that even the nucleus gradually grows indistinct. This 

 is the condition of cloudy swelling (triibe Schwellung), as 

 it is met with in many irritated parts, as an expression 



Fig. 98. Convoluted urinary tubule from the cortex of the kidney in morbus 

 Brightii. a. Tolerably normal epithelium, 6, state of cloudy swelling, c, com- 

 mencing fatty metamorphosis and disintegration. At b and c increased breadth of 

 the tubule. 300 diameters. 



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