EXCRETORY FUNCTION OF THE LIVER. 453 



other of the tissues of the body ; and these experiments, especially Experiments III. and 

 IV., show that the blood that comes from the brain contains a much larger quantity of 

 cholesterine than the blood supplied to this organ. 



The conclusion is, then, that cholesterine is produced in the brain and is taken up by 

 the blood as it passes through this organ. 



But the brain is not the only part where cholesterine is produced. It will be seen by 

 Experiment II. that there is 4'134 per cent., and in Experiment III., 6-308 per cent, of 

 increase in cholesterine in the passage of the blood through the inferior extremities, 

 and probably about the same in other parts of the muscular system. In examining these 

 tissues chemically, we find that the muscles contain no cholesterine, but that it is abun- 

 dant in the nerves ; and, as we have found that the proportion of cholesterine is immense- 

 ly increased in the passage of the blood through the great centre of the nervous system, 

 taken, as the specimens were, from the internal jugular, which collects the blood mainly 

 from the brain and very little from the muscular system, it is very probable that, in the 

 general venous system, the cholesterine which the blood contains is produced in the 

 substance of the nerves. 



If the above conclusion be correct, and if cholesterine be one of the products of the 

 disassimilation of nervous tissue, its formation would be proportionate in activity to the 

 nutrition of the nerves; and any thing which interfered to any great extent with their 

 nutrition would diminish the quantity of cholesterine produced. In the production of 

 urea by the general system, which is analogous to the formation of cholesterine, mus- 

 cular activity increases the quantity, and inaction diminishes it, on account of their 

 influence upon nutrition. In cases of paralysis, we have a diminution of the nutritive 

 forces in the parts affected, especially of the nervous system, which, after a time, becomes 

 so disorganized that, although the cause of the paralysis be removed, the nerves cannot 

 resume their functions. It is true that we have this disorganization taking place to a 

 certain extent in the muscles, but this is by no means so marked as it is in the nerves. 

 We should be able, then, to confirm the observations on animals by examining the 

 blood in cases of paralysis, when we should expect to find a very marked difference in 

 the quantity of cholesterine, between the venous blood coming from the paralyzed parts 

 and the blood from other parts of the body. With this point in view, we made analyses 

 of the blood from both arms, in three cases of hemiplegia : 



Case I. Sarah Rumsby, set. 47, was affected with hemiplegia of the left side. Two 

 years ago she was attacked with apoplexy and was insensible for three days. When she 

 recovered consciousness, she found herself paralyzed on the left side. She said she had 

 epilepsy four or five years before the attack of apoplexy. Now she has entire paralysis 

 of motion of the affected side, with the exception of some slight power over the fingers, 

 but sensation is perfect. The speech is not affected. The general health is good. 



Case II. Anna Wilson, set. 23, Irish, was affected with hemiplegia of the right side. 

 Four months ago she was attacked with apoplexy, from which she recovered in one day, 

 with loss of motion and sensation of the right side. She is now improving and can use 

 the right arm slightly. The leg is not so much improved, because she will make no effort 

 to use it. 



Case III. Honora Sullivan, set. 40, Irish, was affected with hemiplegia of the right 

 side. About six months ago she was attacked with apoplexy and recovered consciousness 

 the next day, with paralysis. The leg was less affected than the arm, from the first. 

 The cause was supposed by Dr. Austin Flint, the attending physician, to be due to an 

 embolus. Her condition is now about the same as regards the arm, but the leg has 

 somewhat improved. 



These cases all occurred at the Blackwell's Island Hospital. The treatment in all 

 consisted of good diet, frictions, passive motion, and use of the paralyzed members as 

 much as possible. 



A small quantity of blood was drawn from both arms in these three cases. It was 



