Secondary or Remote Results of Liver Disease. 431 



Degenerations of the Kidneys are to be largely traced to the 

 same hepatic source. The uric acid diathesis, and the oxalic 

 acid diathesis, both the result of imperfect liver function, are 

 among the most frequent causes of irritation of the kidneys, b}' 

 which channel they are eliminated from the body. Hence acute 

 and chronic nephritis, as well as nephritic calculi result from 

 morbid conditions which hav^e their starting point in the imper- 

 fect function of the liver. Again fatty degeneration of the kid- 

 ne}- is very lial^le to result from derangement of the glycogenic 

 function of the liver, the tendencv to the formation of fat and the 

 constant irritation caused by the pa.ssage of the sugar contributing 

 to the tissue degradation. In such cases albuminuria is a not 

 uncommon accompaniment. 



Derangements of the Digestive Organs may be said to be a 

 nece.ssar}' result of hepatic disorder. Excessive .secretion of bile 

 stimulates peristalsis and may induce diarrhoea, while diminished 

 secretion tends to con.stipation, light colored, fcEtid stools, intes- 

 tinal fermentations and poisoning by the irritant products. A 

 torpid hepatic circulation means congestion of the whole portal 

 sy.stem, indigestions, colics, chronic nnico-enteritis, intestinal 

 hemorrhages, hemorrhoids, etc. 



Derangements of the Nervous Syston. In this connection may 

 be named the lameness of the right shoulder which accompanies 

 certain disorders of the liver, the extreme dullness and depression 

 that attends on others, the sluggish pulse that appears in certain 

 types, the unsteadiness of gait (giddiness) in others, the mu.scular 

 cramps, and irritability in still others. These appear to be due 

 in some instances to the nervous sympathy of one part with an- 

 other, whilst at other times they as manifestly depend on the cir- 

 culation in the blood of partially oxidized and other morbid pro- 

 ducts of hepatic disorder which prove direct poisons to the nervous 

 .system. 



Derangements of the circulation, like extreme rapidit}^ or 

 slowness of the pulse, irregularities in rhythm and intermissions, 

 may be charged more directly on the nervous affection, though 

 primarily determined by hepatic disorder. 



On the part of the Respiratory Orga7is, affections of a chronic 

 type, like sore throat and bronchitis may often be traced to hepatic 

 torpor or disorder. 



