362 PHYSIOLOGY CHAP. 



salivation, but never started the urinary secretion as in the first 

 hysteric. Hypodermic injection of 15 grms. urea, during absence 

 of vomiting and persistent anuria, produced a violent attack of 

 convulsions with sul >secp:ient tetany and coma, which gradually 

 gave way under a tiow of saliva containing urea and sweating 

 promoted by pilocarpine. On the other hand, an injection of 14 

 gnus, urea during a period in which abundant vomiting accom- 

 panied the anuria produced no disturbance. The daily diet was 

 restricted, and the patient was kept entirely in bed. 



Since the tendency of hysterical patients to simulate extra- 

 ordinary phenomena is well known, Kossoni (in order to obtain an 

 unexceptionable proof of the long periods of total anuria) requested 

 the surgeon Crespi to perform a perfect ureterorrhaphy during a 

 period of anuria. After seven days there was complete cicatrisa- 

 tion, with perfect occlusion of the urethral meatus. On the 20th 

 day after the operation, since the patient did not complain of any 

 particular trouble, the urethra was reopened in presence of several 

 well-known Roman doctors, and it was shown by means of a 

 catheter that the bladder did not contain a single drop of urine. A 

 large rubber syringe was kept permanently in the bladder for 10 

 more days, during the whole of which time it was not possible to 

 obtain any urinary secretion. 



These two clinical cases have a double interest for physiologists : 

 (a) because they afford a new objective proof of the excretory 

 function of the entire gastro-intestinal system with its glands, as 

 a substitute for the normally more important function of the 

 kidneys ; (&) because they demonstrate the astonishing fact of a 

 total and prolonged suspension of the renal secretion owing to 

 simple nervous causes. 



Leaving to Chapter VIII. the critical examination of the second 

 phenomenon (which is certainly the most important) we will here 

 confine ourselves to the first point. 



To begin with, we must note with Eossoni that clinical 

 observation does not confirm Charcot's statement that prolonged 

 anuria, as observed at irregular periods in hysterical subjects, 

 must be accompanied by uriuous vomiting in order to avert 

 uraeinic attacks, and to be compatible with life without grave 

 functional disturbances. In the first case vomiting never occurred 

 during the repeated and prolonged attacks of anuria; in the 

 second there were periods of anuria with vomiting and urinous 

 salivation, which were evidently substitutive for the function of 

 the kidneys, but long periods of anuria without vomiting and 

 with mild disturbances were not wanting. When the anuria is 

 accompanied by vomiting, the entire gastro-intestinal canal with 

 its glands (the salivary glands included) takes an active part in 

 the vicarious excretory function ; but when vomiting is absent, 

 we must logically conclude that the lapse of acute uraemic 



