PATHOLOGY. 219 



granular degeneration which is especially marked in the cells of 

 the convoluted tubules but also involves the epithelium covering 

 the glomerular tufts. It is not infrequent for this degeneration 

 to have proceeded so far as to constitute a necrosis. The most 

 striking changes in the glomeruli consist in the degeneration of 

 the epithelium of the tufts v^hich has already been referred to. 

 Intense congestion of the glomerular vessels is practically always 

 present and, in a few cases, a small amount of fluid exudate 

 into Bowman's capsule is found. In no case was the leucocytic 

 exudate into Bowman's capsule excessive. No evidence of prolif- 

 eration of the cells lining Bowman's capsule was seen. In two 

 cases of the series, fibrin thrombi as described by Herzog " con- 

 stituted a very prominent feature in the sections of the glomeruli, 

 (Edema of the kidney is evident in the sections, and very numer- 

 ous, small hjemorrhages which were chiefly situated beneath the 

 capsule were often seen. Some of the cases were the seat of an 

 old chronic interstitial process on which the changes above indi- 

 cated had been superimposed. The finding of casts in the tubules 

 was rare, but the presence of a coagulated fluid exudate or tran- 

 sudate was not at all infrequent. Sections of the mucosa of 

 the pelvis of the kidney were not obtained. 



Liver. — The liver also invariably showed either cloudy swelling 

 or early fatty degeneration. A few small haemorrhages about 2 

 to 3 millimeters in diameter situated beneath the capsule were 

 observed in two cases, in one of which the haemorrhages were 

 also linear in character, measuring as much as one-half centi- 

 meter in length and about 1 or 2 millimeters in width. Small 

 metastatic abscesses such as are occasionally observed in bubonic 

 plague were not encountered in either the liver or the kidney. 



Histological examination of the liver. — The sections show prac- 

 tically always an extensive congestion, and cloudy swelling is a 

 constant feature. While no large areas of necrosis are found, 

 many of the specimens show small areas where one or two or 

 three cells at one place have undergone necrosis. Extensive 

 fatty changes were not noted, although selective stains for fat 

 were impossible. Haemorrhages beneath the capsule occurred, 

 but haemorrhages in the substance of the organ were scarcely ever 

 noted and were never of any extent. In some places the liver cells 

 were considerably compressed by the engorged vessels. In some 

 of the cases rather extensive bile-stasis was manifest by the 

 abundance of biliary pigment contained within the liver cells. 



"P«6. Bur. Govt. Labs. (1904), No. 23, 9. 



