:368 DISEASES OF THE URINARY APPARATUS 



of the kidneys. Their dimensions vary from that of a hazel-nut 

 to that of an apple ; sometimes they become confluent, and may 

 even transform the kidney into a purulent pouch (pyonephrosis) ; 

 the renal tissue is completely destroyed, and the thickened capsule 

 of the organ constitutes a kind of cystic membrane. Such puru- 

 lent cysts have been found weighing thirty-five livres and more. 

 The pus is sometimes gathered in layers which are more or less 

 i:hick, and are located under the capsule of the kidney (Bruck- 

 muller) ; it may work its way into the perirenal connective tissue 

 (paranephritic abscess). 



Symptoms. The symptoms of purulent nephritis not only 

 have nothing characteristic, but they are always masked by the 

 primary affection (pyemia, pyelitis, etc.). Very often we observe 

 but general or rational symptoms, such as emaciation, derangement 

 of the appetite, increase of thirst, weakness, dull hair, etc. In 

 some cases, however, the urine presents characters which clear up 

 the diagnosis; it is fetid, thick, gelatinous, mixed with pus and 

 tube-casts ; blood has also been found in it, as well as mortified 

 renal tissue (Leisering) ; in the cow the tail is often soiled with 

 pus or mucus (Buhler). Later we may observe hemorrhage, em- 

 l3olic pneumonia (Voigtlander), pyemia, etc. ; but the course is 

 slow as a rule, and the renal alterations are only recognized at the 

 autopsy. In the ox, by palpating the kidney per rectum, we may 

 sometimes recognize fluctuation, also purulent cyst of the organ. 



Treatment. The treatment of purulent nephritis is essentially 

 surgical. It consists of the puncture of the abscess through the 

 flank or extirpation of the kidney by laparotomy, Munich has 

 attempted this latter operation upon a cow. Notwithstanding that 

 it has not been followed by success, it must nevertheless be recom- 

 mended, for the ox is not very sensitive to the operative manipu- 

 lations affecting the abdominal cavity, and the slaughter of the 

 animal remains as a last resource should an accident happen which 

 leaves little hope of a cure. 



AMYLOID DEGENERATION OF THE KIDNET. 



Amyloid degeneration of the kidney existing as an essential 

 aflection, isolated^ has been but rarely observed ; generally this 

 degeneration involves several organs at the same time. E-abe has, 

 however, observed this condition in three dogs, and Gerlach (1865) 

 in an ox. 



