of superficial vessels (stellate veins). The _color_ of the cortical
surface depends essentially upon the blood-content and the condition
of the parenchyma. In acute or chronic parenchymatous nephritis the
color is whitish or grayish-white. Localized fatty degeneration and
cloudy swelling cause pale, grayish-yellow, opaque spots or streaks.
Hæmorrhages appear as red or brown-red spots. In extreme passive
congestion the kidney may be a dark purplish-blue (cyanotic kidney).
In hæmorrhagic nephritis the surface may be covered with pin-point
or pin-head hæmorrhages. In pyæmia or acute ascending pyelonephritis
the surface may be dotted with gray or yellowish pin-head abscesses.
Metastatic abscesses are uniformly distributed; others are arranged
in groups. In miliary tuberculosis the surface may contain numbers
of grayish translucent miliary tubercles, with opaque centers when
caseation has taken place. They cannot be so easily scraped out with
the knife as the abscesses. Calcified glomeruli may also appear as
white spots. Proliferations of the interstitial tissue cause large,
red kidneys. Anæmic infarcts are yellow, brick-red or rusty, with
a deeper red zone about them. Pseudomelanosis (usually postmortem)
gives a gray-green color to the kidney. In icterus the color may vary
from brownish-yellow to deep bronze. The _consistence_ of the kidney
is increased in chronic passive congestion, atrophy, interstitial
nephritis and amyloid degeneration; decreased in acute degenerations
and inflammations.
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