Atrophy of the Kidney. 245 



that caused by cysts is the most characteristic. There may be a 

 single cyst or they may be multiple ; they may range in size from 

 a pea to the size of the two fists the total size exceeding that of 

 the normal kidney. In all such cases the cysts project visibly 

 from the surface of the organ. They vary according to their 

 origin and nature. Congenital cysts are said to have resulted 

 from distention by retained urine of the capsule of the glomerulus. 

 The arterial tuft is atrophied and flattened against the wall. 

 Serous cysts with clear contents are found in the old. Urinous 

 cysts again form by distension of the tubules that are obstructed 

 by cysts or minute calculi. Colloid cysts are found in certain 

 forms of nephritis formed by the dilatation of the capsule of the 

 glomerulus or of the uriniferous tubules. The liquid often con- 

 tains leucin, tyrosin and cholesterine. In all such cases the walls 

 of the cyst become thick, and the glandular parenchyma is com- 

 pressed leading to progressive degeneration and atrophy. 



Symptoms of atrophy of the kidney are necessarily those of 

 suppression of urine, with, in certain cases, the passage of casts of 

 the uriniferous tubes and of crystals of salts. There are, how- 

 ever, no absolutely pathognomonic symptoms. When the kidney 

 can be reached through the flaccid walls of a comparatively empty 

 abdomen, or through the rectum, its hard, shrunken condition 

 may assist in diagnosis. 



Treatment is not successful in advanced cases. Prevention is 

 to be sought by ob\aating or treating the conditions on which the 

 atrophy depends. Nephritis must be treated on general principles. 

 Calculi must be avoided by a liberal supply of water, by soiling, 

 or by pasturage. Strongylus parasitism should be dealt with by 

 destroying the parent worms in the bowels, and by securing pure 

 drinking water free from their eggs and embryos. Cysts, and 

 tumors are only amenable to surgical measures and not often 

 open even to these. 



