SECRETION. 



463 



nearly as injurious as the cessation of the 

 eliminating process. In either case, the uri- 

 nary apparatus is the principal channel through 

 which the biliary matter is eliminated ; the 

 urine becomes tinged with the colouring prin- 

 ciple of bile, being sometimes of a yellowish 

 or orange hue, and sometimes of a brown co- 

 lour with a considerable sediment ; and the 

 presence of the most characteristic consti- 

 tuents of the bile has been determined in the 

 urine. The same result presents itself when 

 the biliary duct has been artificially obstructed 

 by ligature. Other secretions have been 

 found tinged with the colouring matter of 

 bile : thus the pancreatic fluid has been seen 

 of a yellow colour in jaundice ; and the milk 

 has presented not merely the hue, but the 

 characteristic bitterness, of the biliary secre- 

 tion. The cutaneous transpiration is not un- 

 frequently so much impregnated with biliary 

 matter, as to communicate the tinge to the 

 linen covering the skin ; and even the sputa 

 of patients affected with bilious fevers have 

 been observed to be similarly coloured, and 

 have been found to contain biliary matter. 

 The secretions of serous membranes, also, 

 have been frequently seen to present the cha- 

 racteristic hue of bile ; and biliary matter has 

 been detected, by analysis, in the fluid of the 

 pleural and peritoneal cavities. 



Biliary matter, however, when unduly pre- 

 sent in the circulating current, is not removed 

 from it by the secreting organs alone; for it 

 seems to be withdrawn also in the ordinary 

 operations of nutrition, entering into combi- 

 nation with the solid tissues. Thus, in per- 

 sons affected with jaundice, we find the skin, 

 the mucous and serous membranes, the lym- 

 phatic glands, the brain, the fibrous tissues, 

 the cartilages, the bones and teeth, and even 

 the hair, penetrated with the colouring mat- 

 ter of the bile, which they must have with- 

 drawn from the blood, and which seems to 

 have a particular affinity for the gelatinous 

 tissues. 



Many instances are on record, in which the 

 secretion of milk has apparently been trans- 

 ferred from the mammary glands to some 

 other surface. It might be expected, fiom 

 what has been already stated regarding kies- 

 tine, that the kidneys should eliminate the 

 constituents of the secretion when the mam- 

 mary glands are unable to do so. Several 

 cases in which this happened are referred to 

 by Voigtel.* One of these, strange to sa}', 

 was a male, who was suffering under tume- 

 faction of the mammary glands, accompanying 

 an attack of catarrh. It is well known that 

 the secretion of milk may be formed by the 

 mammary gland of the male under particular 

 circumstances ; but it could scarcely have 

 been anticipated that it would be produced and 

 eliminated through any other channel. A 

 case has been recorded by Koller, however, 

 in which this was unequivocally the case. A 

 young man, suffering under various ailments, 



* Handbuch der Pathologischen Anatomie, torn. i. 

 583. 



was affected with a vesicular eruption on the 

 skin of the scrotum, which was considerably 

 distended, and on the thighs ; and these ve- 

 sicles discharged a large quantity of a whitish 

 fluid, of somewhat spermatic odour, in which 

 Lowig detected butter, caseous matter, sugar 

 of milk, and alkaline and earthy salts. A 

 fluid, having the appearance of milk, has also 

 been transuded from the skin of the umbi- 

 licus, of the axillae, of the groins, and of the 

 back ; from the gastro-intestinal mucous 

 membrane; from the mucous membrane of 

 the genitals ; and from the surface of an 

 ulcer. The following seems an unequivocal 

 case of the vicarious secretion of milk by a 

 very unusual channel. 



" A lady of delicate constitution (with a 

 predisposition to pneumonia) was prevented 

 from suckling her first child, as she desired, 

 by the following circumstance. Soon after 

 her delivery she had a severe fever, during 

 which her breasts became very large and hard ; 

 the nipples were swollen and firm ; and there 

 was evidently an abundant secretion of milk ; 

 but neither the sucking of the infant, nor any 

 artificial means, could draw a single drop of 

 fluid from the swollen glands. It was clear 

 that the milk-tubes were closed ; and as the 

 breasts continued to grow larger and more 

 painful, purgatives and other means were em- 

 ployed to check the secretion of milk. After 

 three days the fever somewhat diminished, 

 and was replaced by a constant cough, which 

 was at first dry, but soon after was followed 

 by the expectoration of simple mucus. After 

 this the cough diminished in severity, and the 

 expectoration became easy ; but the sputa 

 were no longer mucous, but were composed 

 of a liquid which had all the physical charac- 

 ters of genuine milk. This continued for 

 fifteen days, the quantity of milk expectorated 

 amounting to three ounces or more in the 

 twenty-four hours. The breasts gradually 

 diminished in size ; and by the time that the 

 expectoration ceased, they had regained their 

 natural dimensions. The same complete ob- 

 stacle to the flow of milk from the nipples re- 

 curred after the births of four children suc- 

 cessively, with the same sequel. After the 

 sixth, she had the same symptoms of fever, 

 but this time they were not followed by bron- 

 chitis, or the expectoration of milk ; she had 

 in their stead copious sweatings, which, with 

 other severe symptoms, reduced her to a 

 cachectic state, and terminated fatally in a 

 fortnight."* 



Although the menstrual flux cannot be re- 

 garded in the light of an ordinary secretion, 

 since it consists in great part of actual blood, 

 yet there are indications that it is the means 

 of removing from the body something that is 

 more injurious to it than a mere superfluity of 

 the circulating fluid. A sudden suppression of 

 the catamenia is frequently followed by symp- 

 toms of constitutional disturbance, which 

 neither general nor local abstraction of blood 

 suffices to relieve, and which are only abated 



* Bulletino delle Scienze Mediche, Apr. 1839. 



