The glomencli are changed in several different ways : 1. They resemble the glorneruli in acute exudative nephritis.
They are large, the convolutions of the capillaries are seen with diffi culty, there is a very great increase in the number of the cells which cover the capillaries, but these new cells are not of large size. We also see glomeruli, which apparently have been of this type, small and atrophied.
2. There is an increase not only in the number, but also in the size, of the cells which cover the capillaries. These cells are so large that they project outward from the surface of the glomerulus. There is also an increase in the size and number 'of the cells within the cap illaries. These glomeruli are found stages of atrophy.
3. The capillaries are changed in the same way by a growth of large cells on their outer surfaces and within them. In addition there is a very extensive cell-growth beginning in the cells which line the capsule. The mass of new cells produced in this way may be so great as to compress the capillaries. The glomeruli also become atrophied, the capillaries are shrunken, and the capsule cells changed into connective tissue.
4. If chronic congestion of the kidneys is followed by chronic ne phritis, the dilatation of the capillaries due to the congestion con tinues, and there is added an increase in the size and number of the cells which cover the capillaries.
5. The walls of the capillaries are the seat of waxy degeneration, while the cells which cover them are increased in size and number.
6. Besides the atrophied glomeruli already described, there are others which are small and shrunken with comparatively little new growth of cells.
The arteries are not infrequently much altered by inflammatory changes. There is a growth of cells and basement substances from the inner surface of the artery which obstructs its lumen; or there is a thickening of each of the three coats of the artery ; or all the coats of the artery are thickened and converted into a uniform mass of dense connective tissue; or the wall of the artery undergoes waxy degeneration.