GLANDS. 457 



very small ; sometimes, indeed, none can be detected. But it frequently 

 happens that, after a tube has been stripped of its secreting cells in the 

 manner before mentioned, an accumulation of fatty matter occurs in its 

 interior, the denuded basement membrane becomes scattered over with 

 separate oil-globules, and these increase in size until they form masses of 

 fatty matter, having much the appearance of adipose tissue ; and such a 

 mass is frequently washed out from the tube, and may be detected in the 

 urine. This occasional filling of the tube with fatty matter is very in- 

 teresting in connection with the fact, that in some cases the cysts, which 

 are supposed to be dilated tubes, are also found filled with the same 

 material. In two cases, I have found a cyst as large as a hazel-nut, quite 

 full of oil, presenting all the characters of that seen in the tubes which 

 have lost their epithelium in consequence of chronic inflammation. 



" The evidence, then, of the simple serous cysts being dilated tubes, is 

 the following: 1st. That tubes are often seen much dilated and 

 thickened. 2d. As the inner surface of the tubes has the appearance of 

 being endowed with the power of secreting water, so the cysts usually 

 contain a simple serous fluid. 3d. As an accumulation of oil occasionally 

 occurs in the tubes, so the cysts are in some instances filled with the same 

 material. 4th. There is no reason to suppose that these cysts have any 

 other origin. It appears probable that the Malpighian bodies could not 

 become dilated into cysts, because an accumulation of liquid within the 

 Malpighian capsule would necessarily compress and obliterate the ves- 

 sels of the Malpighian tuft, and so would cut off the further supply of 

 fluid. 



" An6ther change consequent upon the destruction of the cells which 

 line the urinary tubes is, a diminished supply of blood, and a gradual 

 wasting of the tube. I have already shown that there must be a close 

 connection between an increased development of epithelial cells, and an 

 increased afflux of blood to the part. This is well seen in a case of acute 

 desquamative nephritis, and, vice versa, a more or less complete de- 

 struction of the epithelial cells will be attended by a corresponding 

 diminished afflux of blood, and a consequent atrophy of the part affected. 

 In every kidney which has been the subject of chronic inflammation, 

 there may be seen tubes contracted in different degrees, as a consequence 

 of the destruction of their epithelial lining : in some instances, the base- 

 ment membrane becomes folded, and presents an appearance not very 

 unlike white fibrous tissue. As a consequence of this wasting of succes- 

 sive sets of tubes, there is a gradual diminution in the bulk of the cortical 

 portion of kidney, until, at length, the entire organ becomes small, 

 contracted, and granular. When a thin section of a kidney, thus atro- 

 phied, is placed under the microscope, there may be seen an abundance 

 of fibrous tissue ; and this has often been described as new fibrous tissue 

 developed during the progress of the disease ; whereas it is, in reality, 

 nothing more than the atrophied remains of the basement membrane of 

 the tubes, with the healthy fibrous tissue arranged in the form of a 



