Changes of a similar type may be brought about in the kidney by the action of imbibed alcohol in immoderate and continued quantities. There is a similar sequence of cellular changes - cloudy swelling and fatty degeneration of the tubule-cells, increase of fibrous tissue, and eventual shrinkage, with formation of what is termed "granular" kidney of the "coarse red mottled" variety. Among other disorders, the degeneration of the blood-vessels which leads to apoplexy; and albuminuria, giving rise later to diminished excretion of urine as the kidney shrinks, and eventually to Bright's disease, have been recognised as frequent concomitants of alcoholic excess. On the muscle fibres of the heart the effect is to promote protoplasmic change which leads to deposition of fat and eventually to dilatation of the heart, with a consequent weakening of its propulsive power. It is to be noted, however, that all these diseased conditions are found, and very often found, in persons who never take alcohol; they may be brought about by many deleterious agencies, operating singly or in combination. Alcoholism is merely one of these agencies.

Normal

Cloudy swelling.

Fatty degeneration.

Fig. 48. - microscopical sections of human liver.

Showing changes which occur in the course of fatty degeneration. (Horsley and Sturge.) a, Nucleus of liver cell; 6, nucleus of cell forming wall of c; c, a capillary blood-vessel; l, leucocyte or white blood corpuscle; r, red blood corpuscle; / fat droplet.