474 THE SOLIDS. 



of the vascular system invariably occurs. This is a secondary result of 

 the obstruction of the tubuli uriniferi. 



" 3. The oleo-albuminous exudation occurs in two chief forms : viz. 

 first, universal infiltration of the tubes throughout the organ ; and, second 

 infiltration of peculiar sets of tubules : the rest remaining free, or nearly 

 so. In the latter mode arise the granulations of Bright. 



" 4. There is no essential anatomical difference between the exuda- 

 tions in the kidney, which are the result of chronic processes, and those 

 which have been considered as the result of inflammation. 



"5. The capillary vessels of the kidney are subject to spontaneous 

 obliteration (unaccompanied, in the first instance, by any visible lesion of 

 the tubes), giving rise to the peculiar affection which I have called the 

 waxy degeneration. This obliteration of the vessels is probably, in all 

 cases, preceded by a stage of congestion. 



" 6. The consequence of the waxy degeneration is thickening and 

 varicose dilatation of the tubuli throughout the organ. 



" 7. The tubes of the kidney are subject to contraction and oblitera- 

 tion, in consequence of the desquamation of their epithelium ; a condition 

 resulting in atrophy, and complete disorganisation of the organ. 



" 8. The desquamation of the epithelium occurs very frequently in all 

 the other diseased conditions of the kidney. When sufficiently long- 

 continued and extensive, it produces contraction, and this indifferently, 

 whether exudation be present or not. It is sometimes accompanied by 

 vascular congestion in every stage of its progress. 



" 9. The earlier stages of the exudations can only be discovered by 

 means of the microscope. The progress of the waxy degeneration, on 

 the contrary, is best traced by the unaided eye. The desquamation of 

 the epithelium is only to be discovered with certainty by means of the 

 microscope, and is particularly apt to escape attention, under all circum- 

 stances, if the kidney only, and not the urine, be looked to. It results 

 that careful investigation, both by the microscope and the naked eye, 

 both of the kidney after death and the urine during life, are indispens- 

 able, to enable the pathologist to determine with exactitude the presence 

 or absence of disease." 



I have been induced to dwell thus largely on the micro- 

 scopic pathology of the kidney : first, on account of the great 

 importance and interest attached to the lesions of that organ ; 

 secondly, from the great number of interesting facts which the 

 microscope has already brought to light in reference to its 

 pathology ; and, thirdly, in the hope of inducing other ob- 

 servers to follow out more completely the enquiry which has 

 already led to such successful and striking results. 



