vi INTESTINE AS AN OEGAN OF EXCEETION 361 



the prolonged oliguria and anuria which sometimes accompany 

 the course of those complex and uncertain forms of nerve diseases 

 known under the generic name of hysterical neuroses. 



After two cases imperfectly described by Laycock (1838), 

 Charcot (1872) gave a good description of a case in which long 

 periods of total or quasi -total suspension of the renal func- 

 tions were accompanied by sickness, urea and other urinary 

 substances being vomited. Still more classical and important, 

 owing to the accessory phenomena, are two cases of hysterical 

 anuria described by Eossoni (1885), which may be briefly 

 summarised. 



In a hysterical youth of 21 the periods of anuria occurred 

 irregularly, and differed in duration ; there were brief periods 

 perfectly tolerated by the body, and long periods (up to 22 days) 

 with slight disturbances (some headache, malaise, worry, nausea, 

 but complete absence of vomiting). The periods of anuria could 

 always be cut short by pilocarpine, which, besides considerable 

 sweating and flow of saliva containing urea, induced a compara- 

 tively abundant secretion of urine. The exhibition for experimental 

 purposes of 12 grms. urea during the anuria produced an uraemic 

 attack, which gave way to the subcutaneous injection of 0'02 grm. 

 pilocarpine hydrochlorate. During the disease the diet was very 

 scanty, with little nitrogenous food (fruit, dressed vegetables, 

 farinaceous preparations). The patient was kept altogether in 

 bed with complete rest. There was constant constipation from 

 intestinal paresis. The faeces were removed every two or three 

 days by enemata, in amounts varying from 150 to 250 grms. (No 

 chemical examination was made of the faeces.) For twelve days 

 there was acute fever (from 38'8 to 40 -I 7 C.), after which it 

 subsided ; but the temperature for months was above 38 C. 



After about 8 years this patient was suddenly, so to speak 

 " miraculously," cured of all hysterical phenomena, including the 

 periods of anuria or oliguria, in consequence of a strong joyful 

 emotion. 



Another youth of 18 became hysterical after a sudden psychical 

 shock. Violent convulsive attacks, with obstinate nasal and 

 gastric haemorrhage, were followed by ischuria, which in turn was 

 succeeded by irregular periods of oliguria and complete anuria, 

 usually accompanied by vomiting of a fluid which had all the 

 physical and chemical properties of normal human urine. At 

 other times, however, the period of anuria ran its course without 

 grave symptoms (headache, peripheral disturbances of circulation, 

 slight tremor of extremities), and without vomiting as a substitute 

 for the suspended functions of the kidneys. During the illness 

 there was an interval of 50-60 days, in which the periods of total 

 anuria were not accompanied by vomiting. In this patient the 

 administration of pilocarpine during anuria produced sweating and 



