NATURE AXD HISTORY. 369 



The condition recognised by the term azoturia, or nitro- 

 genous urine, although in our day freely spoken of as some- 

 thing new or strange, has apparently been well enough recog- 

 nised by many who have preceded us. In many of the 

 published records of disease, affections apparently of this 

 character have been confounded and grouped with others, 

 which, although somewhat similar in many of their features of 

 development, are yet in true character and origin essentially 

 different. 



As respects the nature of this disturbance, in as far as con- 

 sequents are related to antecedents, there is probably not much 

 disagreement. All seem pretty well satisfied that it is the 

 result of an over-supply or presence in the system of nitro- 

 genous material, and that to this plethora of these albuminous 

 or azotized ingredients are to be attributed those phenomena so 

 characteristic of the affection. It is when we come to speak of 

 the manner or mode of action by which this superabundant 

 nutritive material operates in the production of the results we 

 call symptoms, that we arrive at divergence of opinion and 

 puzzling explanations. 



There seems little doubt that for some time antecedent to the 

 development of the distinguishing features of the disease, the 

 muscular spasms, or paraplegia, and altered urinary secretion, 

 there have been changes and disturbances occurring in the 

 complex process of assimilation in one or more of the steps which 

 exist between the passage of the chyle from the intestine and 

 the period when it is fitted for serving the purjDoses of healthy 

 pabulum. It is certainly obvious that whatever the pathological 

 changes may be, and however they are carried out in the disease, 

 that the muscular elements of the body are very largely, pro- 

 bably more largely, affected than any other structures. Whether 

 these tissues and elemental structures are primarily affected 

 through the contact of abnormal and unwholesome nutritive 

 material acting upon and destroying their inherent power of 

 contractility, or whether we are to look to the poisoning of the 

 nerve-centres directly, or to the influence of the operation of reflex 

 action, for the occurrence of the clonic or tonic contraction and 

 ultimate paralysis of the muscles affected, seems rather doubtful. 

 We may, however, with safety regard the uriemic condition of 

 the urine — one of the diagnostic sj^mptoms of the disease — as 



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