Urccmia; Thyroid Disturbances. 459 



The effect of disturbances of the uropoietic system upon the 

 general body depends upon the extent and the kind of the 

 changes. All the bacterial processes in the kidneys and in the 

 collecting- receptacles (bladder, renal pelves) as well as the 

 damming back of the urine in the ureters bilaterally, sooner or 

 later bring about symptoms of intoxication, manifesting them- 

 selves especially by symptoms of cerebral depression, less fre- 

 quently cerebral excitation, included collectively under the 

 term urcniiia. This is partly referable to the impaired excretion 

 from the blood of substances no longer of use in the economy 

 and having toxic influences when retained, as the products of 

 proteid decomposition particularly; and the kidney is itself a place 

 in which special metabolic processes are carried on, the products 

 of which, as hippuric acid ( Bunge and Schmiedeberg), if retained 

 may apparently take part in the production of uraemia. The 

 regulation of the proportion of water in the blood is apt to be 

 disturbed in chronic renal aft'ections ; and, too, because of shrink- 

 age of the comparatively large capillary area of the kidneys, a 

 certain amount of resistance is likely to develop to the arterial 

 blood flow ; in these chronic affections, therefore, hydremia, cardiac 

 hypertrophy and general dropsy may be expected as secondary 

 features. 



Disturbances of the Thyroid Function- 

 Destruction of the thyroid tissue by atrophy, degenerative 

 processes or heterologous tumors, involves the loss of an organic 

 function of vital importance ; disturbances of nutrition, loss of 

 physical strength and spasmodic attacks being induced, indicative 

 of a general autointoxication of the body and leading to a fatal 

 termination. In case of total extirpation of the thyroid gland 

 [including the parathyroids] intense nervous symptoms (delirium, 

 tetanic convulsions, and so-called tetany) quickly appear, as ob- 

 served in man. Dogs usually die after such operations in from 

 three to twenty-eight days and, too, under circumstances where 

 injurv to nerves, etc.. cannot be held responsible. After removal 

 of large portions of the thyroid there is also danger of autointoxi- 

 cation. Where the symptoms develop slowly, as is particularly 

 true in pathological atrophy of the glandular tissue, the resultant 

 condition is spoken of as cachexia strumipriva or athyrea; and 

 besides the nervous symptoms there may be observed spasmodic 



