ON ECK'S fistula II 



liver. Something other than ammonia must have been the cause of 

 death. 



It would occupy too much space to discuss the observations of 

 Magnanimi and von Karltreu here. They are rendered valueless in this 

 connection by a collateral circulation which developed around the liver. 



I have given a fairly extensive review of the work of the St. 

 Petersburg observers in this direction, as I believe that, although widely 

 known in a general way, the exact details of this most interesting 

 experimental disease are little known. With the recent simplification by 

 Sweet and Herrick in the technique of Eck's operation, more extensive 

 observations of the symptoms are rendered possible, and the question as 

 to whether carbamate or ammonium poisoning is their cause, or whether 

 they are not due to some other poisonous body (toxin), should not long 

 remain an open one. 



The behaviour of several of the dogs operated on by Sweet was 

 observed by P. B. Hawk (i3). Only mild, transient symptoms were 

 noted when flesh powder was given, but they were much more severe 

 when meat extract or fresh flesh was also given. 



It was further noted that the injection of sodium carbamate did not 

 produce any symptoms similar to those observed in dogs with Eck's 

 fistula, either when the salt was given to normal or to Eck fistula dogs. 



Rothberger and Winterberg (i4) have recently communicated a series 

 of very accurate observations on twenty-two dogs in which Eck's 

 operation had been performed. They conclude that the symptoms are 

 probably not due to carbamate intoxication, but rather to some other 

 toxic substance which the liver normally destroys. In this connection 

 they point out the extreme importance of the liver in antagonising the 

 action of many poisons {e.g., strychnine), when these are absorbed into 

 the portal blood from the intestine. In comparing the symptoms, 

 presented by Eck fistula dogs, with those induced by administration 

 of carbamate or substances which would produce it, they found very 

 considerable differences. 



I shall in this connection offer a brief account of some observations 

 on the general condition of four Eck's fistula dogs operated on by Dr. F. 

 C. Herrick. I shall then give the results of a chemical examination of 

 the urine of three of these animals. Unfortunately, the blood and 

 organs were not examined for their ammonia content. 



(275) T I 



