Htzmoglobinamia. — Azotemia, Etc. 447 



matismal may be correctly applied to almost all cases that we meet 

 in practice. They quote Goring as having produced the disease 

 experimentally by exposure to cold, and go on to explain that 

 rest in the stable before the attack causes the extreme sensitive- 

 ness to cold that is generated by a warm environment. The im- 

 plication of the lumbar, pelvic and femoral muscles they explain 

 by the stimulation of the nutritive metamorphosis by the action 

 of cold on the sensitive nerves of the skin. The effect of this 

 cutaneous irritation is exaggerated by the heat of the stable to 

 which they have been previously subjected. The products of 

 the destruction of the albuminoids of the muscles, pass into the 

 blood as hsemoglobin, and produce the ulterior phenomena. The 

 muscles of the hind quarters especially suffer because of their 

 greater exposure and because they are subjected to the hardest 

 work in propelling the animal machine. In this connection they 

 quote the experiments of L,assar and Nassaroff in which sudden 

 exposure to cold determines parenchymatous degeneration of 

 muscles ; also the cases of paroxysmal or winter hsemoglobi- 

 nuria in certain susceptible men whenever they are exposed to 

 an extremely low temperature. 



There are serious objections to the acceptance of this as the 

 essential cause, among which the following may be named : 



1 st. The disease is not confined to the cold season but occurs 

 also at midsummer when the out-door temperature is even higher 

 than it is in the stable. 



2d. In our Northern States it appears to be more common in 

 spring and autumn or early winter, when the extreme colds have 

 either already passed, or have not yet set in, but when the abrupt 

 changes of weather (rain-storms, etc. ) are liable to shut up the 

 animal indoors for a day or more at a time. 



3d. The popular names quoted with approval by these authors 

 — Monday disease, Easter disease, Whitsuntide disease — indicate 

 the prevalence in Europe also, of the malady in the milder, or 

 more temperate seasons rather than during the prevalence of ex- 

 treme cold. 



4th. The fact that the disease rarely or never occurs in the 

 stable, no matter how cold the season, how open the wooden 

 walls or floor, nor how strong the draft between doors, or win- 

 dows, shows that the theory of cold as the sole or main cause 

 must be discarded. 



