CONGESTION OF THE KIDNEYS. 



359 



often connected with inflammation. Like this, it is developed 

 under the influence of infectious or toxic principles exercising their 

 action upon the renal epithelium. According to its stage we dis- 

 tinguish : 1. Turbid tumefaction (granulous trouble). 2, Fatty 

 degeneration. 3. "Hydropic^' degeneration. 4. Necrosis of the 

 renal epithelium. 



Symptoms. The most important and often the only manifesta- 

 tions of nephritis (in the course of infectious diseases, for instance) 

 are furnished by the urine. Its quantity is diminished; it is 

 thickened, albuminous (from 0.3 to 1 per cent, of albumin in 

 man); its specific gravity is increased ; it is often turbid and also of 

 abnormal color ; occasionally we observe hematuria. 



With the microscope we see a more or less large number of 

 cylinders in the urine, which are partially or totally covered with 

 cells, with leucocytes and red corpuscles ; we discover, besides, 

 numerous epithelial cells within, also white or red corpuscles, ac- 

 cording to the desquamative, interstitial, or hemorrhagic character 

 taken by the nephritis. Micturition is painful ; the urine often 

 runs off drop by drop only, notwithstanding the violent efforts made 

 by the patients (strangury, dysuria). In serious cases the urinary 

 secretion may be completely suppressed ; Funk has observed an 

 anuria of five days in a cow, and Friedberger one of seven days in a 

 horse. This latter symptom is due to the obstruction of the urin- 

 iferous canaliculi by fibrinous cylinders and to the diminution of 

 excretion in the diseased organ. The lumbar region is very sen- 

 sitive to the pressure of the hand. In a rectal exploration we 

 always find the bladder empty ; the kidneys seem to have increased 

 in size ; they are sensitive to pressure. At the beginning of the 

 disease we often observe renal colics ; the back is arched, the gait 

 stiff and staggering, rising is very painful ; the animals remain 

 almost constantly standing, with their legs outstretched or gathered 

 under the body. In unilateral nephritis, the leg of the diseased 

 side is oftentimes dragged during the walk, or it covers less ground 

 ' than the corresponding limb on the opposite side. In males, one 

 of the testicles is frequently higher (Roll). 



From the beginning, the appetite may be suppressed ; in the dog 

 vomiting is not unusual, and is habitually followed by constipation, 

 and this later on alternates with diarrhea. The elevation of the 

 temperature is moderate as long as there are no uremic complica- 

 tions ; the pulse, strong and hard at the start, becomes afterward 



