81 
URINARY SYSTEM. 
KIDNEYS. 
Idaho . — Collister (1896, p. 63) states that the kidneys are often disturbed. 
Montana . — Gates (1905, pp. 115) mentions severe parenchymatous inflammation for 
his case 10 (1903), and says that the kidneys suffered especially in case 12 (1903). 
G’.vinn (1902) reports slight enlargement of the kidneys in one case on post-mortem. 
Referring to pathology IVilson and Chowning (1903a, p. 67; 1901a, p. 42) state that 
in all cases examined one or both kidneys showed small subcapsular hemorrhages 
on the ventral surface; the cortex on section was congested. Upon microscopic 
examination numerous phagocytes were found, each containing from 1 to 8 faintly 
outlined red blood cells, in nearly every one of which is a parasite; the kidney 
shows acute parenchymatous nephritis. Later (1904a, pp. 42, 43) they add that the 
capsule strips readily and there is some extravasation of red-blood cells, particularly 
in the cortex. Anderson (1903c, p. 38) summarizing autopsies on 7 cases (including 
the 6 autopsies reported by Wilson and Chowning, 1903a) states that the kidneys are 
enlarged; capsule usually not adherent; small subcapsular hemorrhages on ventral 
surface; on section, congested and swollen cortex; pyramids well outlined and deep 
red in color; small hemorrhages in pelvis; microscopically there are minute extrav- 
asations of blood in cortex and under the capsule; veins fllled with blood; nuclei of 
convoluted tubules stain poorly; cells granular and in some places detached; newly 
formed casts in tubules; bladder normal and usually with small amount of dark 
urine. 
In case 3 there were small subcapsular hemorrhages in both kidneys. In case 89 
a small ecchymotic area was present immediately underneath the capsule on the 
anterior surface of the right kidney; the left kidney showed no ecchymotic areas, 
but otherwise was like the right kidney. In case 91 several minute hemorrhagic 
spots were present in the capsule over the ventral surface of each kidney. In case 
94 the left kidney was normal in size and there was a hemorrhagic area near upper 
pole and on anterior surface; the right kidney was normal, except on section (see 
below). In case 97 the left kidney was about normal in size; the right kidney was 
small; fetal lobation was present. In case 107, 2 or 3 ecchymotic hemorrhages were 
present in the ventral portion of the capsule over the left kidney. — Wilson and 
Chowning, 1903c, pp. 48, 51, 53, 55, 56, 58. Anderson reports (1903c, p. 33) in 
reference to case 120 that the kidneys were enlarged; the left kidney weighed 10 
ounces; there were minute subcapsular hemorrhages, especially over the greater 
curvature. 
In case 11 \1901) the right kidney measured 12 by 7 cm. ; the left 
kidney measured 13 by 7 by 6 cm., areas of distinct pallor were scat- 
tered over the surface. 
In cases 89 and 94 the capsule stripped easily. In case 97 the capsule was adher- 
ent and slightly hemorrhagic in the left kidney, but the capsule stripped easily 
from the right kidney. — Wilson and Chowning, 1903a, pp. 51, 56, 58. Anderson 
( 1903c, p. 33 ) reports the capsule as adherent on the left kidney in case 120. 
In case 11 (1901) the capsules of both kidneys were adherent, carry- 
ing substance with them in removal. 
In case 3 the cortex of both kidneys, on section, was slightly congested. In case 
89 the section of the cortex appeared slightly congested. In case 91 the section of 
both kidneys was congested, but otherwise normal. In case 94 the cortex of the 
left kidney was normal in thickness, with hemorrhagic areas over the cut surface; 
the pelvis was normal; in the right kidney similar hemorrhagic areas were seen, but 
23339— Xo. 20—05 6 
