The increase of connective tissue is first observed in the interlobular spaces, and later dips down into the lobules. The atrophy of liver cells follows this increase of interstitial connective tissue. (Plate vi.)
On gross examination the kidney is found to be larger and heavier than normal. In consistency it is either firm or soft and edematous, presenting a mottled surface, the result of infarction. The capsule strips readily or is thickened and adherent as in severe cases. The Malpighian bodies are either prominent and swollen or sunken and atrophied. These conditions are often present in the same specimen. On cut section the color of the kidney varies from the normal to a yellowish brown, marked by opaque, dark and minute hemorrhagic areas. The medullary rays are pale, showing between them dark, red lines of congested intertubular vessels. The cortex is generally thick and paler than normal. It is translucent
WHITING ED. MALARIA. JAMA. 1896;XXVII(6):318–323. doi:10.1001/jama.1896.02430840034002j
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