On the pathology and treatment of albuminuria / by W. Howship Dickinson.

Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and treatment of albuminuria / by W. Howship Dickinson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Under tlie microscope1 tlie cortical tubes are seen to be stuffed with an opaque brown material, which so long as it remains in the tube does not display any structure, but looks uniformly granular. Spread out on the glass it is seen to consist of cells of epithelium, not changed except- ing that they may be stained of a brownish colour, beside blood corpuscles and indefinite granular matter; the latter probably resulting from disintegration of the epithelial cells. This condition is most marked in the convoluted tubes, but the straight usually contain more or less of the same material. Beside the cell growth there is usually fibrinous exudation in the tubes. In some cases (Vallance, p. 95) tins is fatally abundant. The malpighian bodies stand out prominently, and their vessel is seen to be distended with blood corpuscles. There are no other changes in the organ. The tubes are 1 A few words upon the mode of examining the kidney microscopically may he of service. The state of the epithelium is best known by scraping the cut surface, and placing a minute portion of the debris gathered on the knife, with a drop of water, under a quarter or eighth object-glass. By this plan tubes are often detached also, but these structures are best displayed in a section. To obtain this a double-bladed knife may be used ; but the best way is to expose a small piece of the organ—a cubic half-inch—to the action of a mixture of ice and salt, by which, in about a quarter of an hour, it becomes perfectly hard, so that sections of any degree of tenuity can be cut with a sharp scalpel or razor. Sections made in this manner are adapted to show the effects of reagents, indigo, iodine, &c. This plan will also show the fibrous tissue, but it is found that the inter- tubular structures and the attachment of the capsule are seen with more dis- tinctness in the smoother sections which can be made from portions hardened by boiling or by chromic acid. The best results are obtained by hardening a piece of the organ in chromic acid, and making transparent sections therefrom by a modification of the method introduced by Dr. Lockhart Clarke. A piece of kidney is hardened in a solution of chromic acid (about 1 in 300), or the process of hardening is commenced in chromic acid and completed in spirit. Sections are then tinted with carmine, or, if it be desired to examine the nuclei, with logwood. After saturation with absolute alcohol they can then be made beautifully transparent with oil of cloves, and finally put up in Canada balsam or damar varnish, in which they will remain as imperishable memorials of the patient from whose body they were obtained. (See plates 5 and 9.) The beauty and clearness of the sections obtained by this method leave nothing to be desired. The plan is applicable to many other structures. Tubes stuffed with epi- thelium,