For some years the attention of writers has been attracted toward the kidney lesions, all the More as the participation of these organs in the disease process is often very significant clinically and occupies the foreground in the symptomatology.
Here also the severity and duration of the disease plays an im portant part, and on this account the works of different writers show pronounced differences. The epithelium of the convoluted tubules is a site of predilection for the lesions. Kjellberg found there fatty de generation, while the lumina were filled with fat and granular masses, and the cells of the straight tubules showed cloudy swelling. This finding has been frequently confirmed, and seems to be fairly constant in acute diseases of nutrition of severe course. T have heen able to demonstrate it in the majority of the cases examined. The literature on the subject has been collected by J. Pick. He was able to show in osmic acid preparations, that the fatty degeneration was not confined to the places mentioned, but was also found in some glomeruli, and in the epithelium of the. iffalpighian tufts. In addition, there is marked hyper:rmia of the entire renal cortex, proliferation of epithelium in some of the Bowman's capsules, and areas of cell infiltration at the boundary of medulla and cortex. In chronic cases the changes are
mainly found in the vessels, in the form of capillary inflammation, arte ritis, phlebitis, and areas of infiltration with leucocytes. Clomerular nephritis also is at times observed tlicubner, de Rothschild, et al.).
The frequent occurrence of spasm, contractures, and paralyses in the course of acute and chronic diseases of nutrition has directed attention to the histologje examination of the central nervous system. Zappert believed he had found the anatomic basis of the spastic condi tion of the extremities so frequently present in a degeneration of the anterior nerve-roots. Thiemich disputes this, failing to find a corre sponding lesion in paralysis of the cranial nerves. Also Milner and Manicatide, working with Ni.ssrs method, were able to demonstrate various cell changes, pointing toward an infectious or toxic origin, but were not able to establish a type characteristic of diseases of nutrition.