26o CIJMCAI, VKTKRINARV IMKDICIXE AND SLR(;p:K\. 



tion of haemoglobin which might originate from the colouring material 

 of the altered muscles. 



The results following attempts to produce experimental hsemoglo- 

 binuria in no way favour the renal theory. Hsemoglobin&emia, with or 

 without hemoglobinuria, ma}' be produced b}' introducing into the 

 blood substances which cause destruction of a greater or less number of 

 red blood-corpuscles, and thus set at liberty varying quantities of haemo- 

 globin, capable of conversion into methaimoglobin and many other still 

 unknown metabolic products. If few red blood-corpuscles are destroyed, 

 slight hasmoglobinaemia without hemoglobinuria is produced : hsemo- 

 globin is soon broken up by the liver, spleen, and bone marrow. The 

 same result follows, even though destruction is more abundant, provided 

 it occurs gradually ; neither haemoglobinuria nor visible changes in the 

 kidneys are seen. On the contrary, if it is abundant and rapid, hemo- 

 globinuria appears, and the kidneys undergo more or less gra\'e change. 

 Hemoglobinemia, hemoglobinuria, and disease of the kidney constitute 

 the three stages of hemoglobinuria experimentall}' produced. Spontane- 

 ous hemoglobinuria is very probably marked by similar stages. What 

 remains to be discovered is the cause or agent which in the spontaneous 

 form sets at liberty the hemoglobin. 



The conditions under which the disease appears, the sudden invasion, 

 preliminary colicky pains, and the multiplicity of organs almost imme- 

 diately affected, suggest that it results from toxic infection of intestinal 

 origin, of which the hemoglobinemia, hemoglobinuria, and the changes 

 in muscle and in the spinal cord are only the principal manifestations. 

 Not onl}' does the intestine present a vast cavity for the growth of 

 pathogenic microbes ; it is also a centre of manufacture for toxins. 

 Overfeeding of horses while idle favours the production of intestinal 

 poisons ; and it is known that when associated, otherwise relatively 

 harmless germs, like the Bacillus coli connnunis, the paracoli bacilli, 

 and the streptococci, may produce deadly toxins. In processes of this 

 nature intoxication irxa}- play an e\en more important part than infec- 

 tion.* 



The diagnosis of hemoglobinuria is usuall}- easy. Nevertheless 

 benign cases may at first be mistaken either for intestinal colic or for 

 muscular rheumatism. Others, where the animal is lying down when 

 examined, may suggest traumatic paraplegia or fracture of the vertebral 



* M. Lignieres found streptococci in the cerebro-spinal fluid of horses dead of hc-emo- 

 globinuria. This discovery, however, only shows that streptococci, without doubt originating 

 in the intestine, had entered the blood-stream. It remains to be proved that this was not a 

 case of organisnvs entering the circulation during the death agonv. 



