The investigation and treatment of cases of bilateral
cortical necrosis of the kidneys has chiefly fallen to the lot
of the obstetrician. There are now, however, an appreciable
number of recorded cases which have occurred without the common . association of pregnancy and indeed several cases have occurred
The total number of authentic cases which has been
recorded in the literature is about forty -two. Last year Kellar
and Arnott (1) reported three cases, Johnstone(1) one, Baird and
Dunn (2) one which now brings the total number to forty - seven.
The condition can no longer be regarded as a rarity although very
uncommon, and indeed most pathologists and obstetricians of experience will have met with one or more examples. Professor F.J.
Browne of University College told me that he had met with a case
very recently. The total number of recorded cases of a disease
rarity is not by any means an accurate index of its actual occurrence.
Clinically the condition is characterised by a profound.'
or total anuria and with the striking pathological picture of
almost complete necrosis of the renal cortex it forms an entity
which is readily recognisable.
It is interesting to note that during the past twenty - seven years no less than fourteen cases of this type have been
reported to the Edinburgh Obstetrical Society. Jardine and Kenn
edy (3), Davidson and Turner (4), Kellar and Arnott (1). It is
probable that this has a direct relationship to the high incidencE
of toxaemia in Scotland.
In this short essay I shall first detail the four cases
of this condition which I have studied and then proceed to a
short discussion with reference to the literature on the subject.
All the kidney sections were stained haematoxylin and
eosin and also with azan. In one case the alizarin stain for
calcium was also employed. In case one a whole block section of
the kidney was made but it was found after staining that there
was no great contrast in the colour between the necrotic and the
non -necrotic portions of the kidney and the striking naked eye
appearance was to a great extent lost.