GLANDS. 465 



vascularity; sometimes, however, they are of a pale colour and their 

 bases are indistinctly marked, a condition which indicates the progress 

 towards a further disorganisation. 



" When a kidney in this condition is carefully and minutely injected, 

 the greater proportion of the cortical substance remains impervious; 

 the injection, however, can frequently be made to penetrate as far as the 

 cortical stria?, and even to some of the Malpighian bodies. (See Rayer, 

 Plate X.^%. 2 ; Bright, Plate II. fig. 3.) 



" From these circumstances it is obvious, that the lesion above described 

 consists in an obliteration or obstruction of the capillary system of vessels 

 throughout the organ, and a partial obliteration of the veins on its surface. 

 There is also every probability that this condition is secondary to one in 

 which there is a high degree of congestion of the organ. The extrava- 

 sations, the occasionally injected Malpighian bodies, and the highly in- 

 jected though partially distributed stellar veins, leave no doubt that the 

 state of congestion described as the first form of albuminous nephritis by 

 Rayer, is really the antecedent of the present or second from. 



" To any one who is familiar with the marbled and waxy kidney here 

 described, there can be no difficulty in recognising a further stage of the 

 same lesion, in which the organ is perfectly pale both on the surface and 

 on section, with the exception perhaps of a very few stellated superficial 

 veins. The kidney in this stage (the transition to which seems to be re- 

 presented in Rayer, Plate VI. fig. 4.) is still heavy and voluminous ; it 

 acquires additional firmness and elasticity, and assumes much of the 

 general appearance of a true non-vascular texture. It varies from a 

 light yellow to a fawn colour, which extends to the pyramids, the bases 

 of which become still more confused and intermingled with the cortical 

 substance than in the marbled kidney. The capsule is frequently more 

 firmly adherent to the external surface than in health. 



" From the pale and yellow appearance of the kidney in this stage, it 

 is very apt to be mistaken, even by a practised eye, for an extreme de- 

 gree of the fatty degeneration. A well-marked example, indeed, will 

 hardly give rise to this error," if attention be directed to the degree of 

 firmness of the organ, the peculiar lustrous character of the cut surface, 

 and the entire absence of the opaque granulations of Bright, or of that 

 dull tint which distinguishes the excessive degrees of the fatty disease. 

 The appreciation of these characters is, however, more difficult where, as 

 sometimes happens, exudation is also present ; and the distinction which 

 has escaped the acute observation of M. Rayer, has undoubtedly been 

 overlooked by many other observers. 



" The microscopic characters of this lesion are chiefly negative. There 

 is not unfrequently an entire absence of exudation ; indeed, in the most 

 marked cases of the lesion I have seldom found even the slightest trace 

 of any abnormal deposit. Occasionally, however, there is a very minute 

 quantity of fatty exudation in the tubes, generally in very small granules, 

 and scattered throughout the organ. The tubes are either natural, or in 



pp 4 



