AUTOPSIES AT THE PHILIPPINE MEDICAL SCHOOL. 215 



with scattered plates of calcification confined to the abdominal aorta. 

 The other 4 showed numerous flat, yellowish, oval projections scattered 

 over the surface of the aorta near its origin. ISTo change more marked 

 than a partial loss of elasticity was encountered in the vessel walls, even 

 in cases over 60 years of age. Arterio-sclerosis was found in but one of 

 the 25 individuals infected with tuberculosis. 



Aneurism was not encountered in any of the series, nor has a case been 

 admitted in the hospital wards or been seen among the patients of the 

 large free clinic at St. Paul's Hospital during the past eight months. 



DISEASES OF THE KIDNEYS. 



Lesions of the kidneys occurred more frequently than one might expect 

 from the generally good condition of the arterial tissue. Of 100 cases, 

 nephritis was present in 48, acute in 23 and chronic in 25. Eetention 

 cysts occurred in 7, infarcts in 2, and tuberculous foci in 4 cases. 



The kidneys usually appeared swollen and markedly congested in the 

 instances of acute nephritis, the capsule stripping readily and leaving a 

 dark, smoky surface. Histologically, the glomerular changes predom- 

 inated, the capsules and tubules frequently containing red and a few 

 white blood cells. The swelling and granular appearance of the tubular 

 epithelium was in most instances less marked than the glomerular change. 



The kidneys with chronic nephritic changes were of the large, pale type 

 in 6, and the small granular in 19 cases. Two cases of the first group 

 showed large, pale, swollen organs with numerous opaque areas scattered 

 over the smooth surface beneath the capsule; the pale cortex forming 

 a sharp contrast to the darkly injected pyramids. Histologically, the 

 tubules, glomeruli, and interstitial tissue were all more or less involved 

 in the imflammatory process. The four other cases of this group evi- 

 denced somewhat small, pale kidneys with thickened capsules and rough- 

 ened surfaces. Glomerular degeneration and a rather marked grade of 

 of interstitial change was present, hyaline changes being frequent. 



Contracted, roughened kidneys with firmly adherent capsules were 

 found in seven instances in the remaining nineteen cases of chronic 

 nephritis. The capsules covered small cysts. This type of kidney could 

 only be cut with increased resistance; it showed an attenuated cortex 

 which contained a greatly . increased amount of interstitial tissue, with 

 marked degenerative and atrophic changes in the glomeruli and plugging 

 of distorted tubules with debris. The arterial change in these cases of 

 chronic nephritis is less marked than the general change in the organs 

 would lead one to expect, with the exception of those cases in which 

 there was a general arterio-sclerosis. 



Fatty degeneration of the kidney was found in 4 cases, 3 of which 

 died of tuberculosis and 1 of amoebic dysentery. 



The suprarenal bodies were tuberculous in two instances, both of which 

 contained, in addition, marked pulmonary lesions. 



