Abstract
It is a well known fact that function is often disturbed without corresponding anatomic lesion. There is always a suspicion, however, that the lack of demonstrable lesion is only apparent and really to be attributed to our crude methods of investigation and our lack of knowledge of the physiologic arrangements. As the Altmann method reveals some very fine details of the protoplasm, and as Altmann has shown that during normal function, especially when stimulated by injections of pilocarpin, the appearance and arrangement of the granules, brought out by his method in the protoplasm, changes quite remarkably, they being in many cases extruded to form part of the secretion, I thought it interesting to see whether these structures would serve as indicators of any primary alteration in the protoplasm of cells during functional disturbances.
The kidney appeared to be the organ best suited for this purpose as by collection of the urine directly after its discharge from the ureters, the exact moment of the occurrence of the disturbance could be ascertained. It is possible to produce albuminuria in dogs within a few hours by intravenous injection of bichromate of potash (about 2-3 c.c. of a 2% solution). If Altmann's specimens are made from the kidneys at this time no lesions are found. That the poison nevertheless acts upon the epithelial cells and the granules in them is shown by the subsequent development of severe lesion in them.
In phloridzin glycosuria, likewise, no lesions are demonstrable by this method, although we are fairly certain that the excretion of sugar in this case is due to a lesion in the kidney.
I am inclined to believe that quite a few of the anatomic changes which we now look upon as primary are the result rather than the cause of the functional disturbance, although the disarrangement brought about by them naturally often aggravates the original condition.
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