H^EMOGEOBIN^EMIA. AZOTEMIA. AZOTURIA. HE- 

 MOGLOBINURIA. TOXEMIA PROM IMPERFECT 

 HEPATIC FUNCTION. 



Definition. Theories, of hysteria, uraemia, spinal myelitis, myelo-renal 

 congestion, rheumatic lumbago, myosito-myelo-nephritis, rheumatic chill 

 with destruction of muscle albuminoids. Yet it occurs in our semi-tropical 

 midsummer with a temperature of 80 or 90, in spring and autumn, and rarely 

 even in the cold, damp stable in midwinter in the absence of exercise. 

 Constant conditions : One or more days absolute rest, following steady 

 work, a strongly nitrogenous ration, continued during the rest, sudden act- 

 ive exertion, accelerated breathing and unloading of peptones and proteids 

 from portal vein and liver into the general circulation. Sanguineous albu- 

 minuria from excess of albuminous food, free ingestion of water, suppressed 

 milk secretion, forced marches. Transfusion of blood. Excess of albumen 

 dangerous, excess of red globules not dangerous. The blood concentration 

 of diuresis or diaphoresis is not dangerous. Continuous muscle decomposi- 

 tion from work bars the disease. Stable miasm untenable. Poison may be 

 drawn suddenly from the enormous mass of blood in the liver, spleen and 

 portal system. The absence of icterus antagonizes the bile theory. Ben- 

 zoic acid, unaltered peptones, and glycogen are examples of elements de- 

 structive to blood. Normal destruction of red globules in liver, spleen and 

 bone marrow. Sudden access of resulting haemoglobin to the blood. Other 

 products of disintegrated globules. Poisons from food, and antitoxic action 

 of liver in presence of glycogen. Carbon dioxide favors solution of red glob 

 ules. Theoriesof haemoglobinaemiainman. Microbes. Lesions : Blood black, 

 diffluent, irridescent, has no avidity for oxygen , with excess of urea and ex- 

 tractives, serum of clot red, globules small, pale, distorted, not sticky ; ex- 

 travasations ; liver, enlarged, congested, blood gorged ; spleen congested, 

 swollen : Lumbar or gluteal muscles pale, infiltrated with loss of striation ; 

 bone marrow congested, hemorrhagic : kidneys congested infarcted ; urine 

 dark brown or red, with excess of urea and haemoglobin. End of spinal 

 cord has congestion or infiltration. Symptoms : History of high condition, 

 constant work, high feeding, a day's rest, then exercise and attack. To 

 full life, follows flagging, droops, moves one or both hind limbs stiffly, 

 knuckles, drags toes, crouches, trembles, perspires, breathes rapidly, is ten- 

 der on back, loins, croup or thigh, muscles firm, paretic, and drops unable 

 to rise. Urine retained, brown, red or black, sometimes glairy, later may 

 have casts. Appetite may return. In mild cases, stiffness, lameness, with 

 or without visible muscular lesions or tremors. Urine glairy, dense, with 

 excess of urea and nitrogenous products. Recover under careful feeding 

 and exercise, and relapse under original causes. Progress : May recover 

 under rest. In bad cases accelerated breathing and recumbency forbid rest 

 and recovery. Recovery in a few hours or after a week. Urinary casts 



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