REDUCTION OF ALBUMINOIDS. 



A large proportion of the fibriue formers are changed in pass- 

 ing through the liver (Lehniann, Bernard), in man as much as 

 2,690 grammes daily (Brown Sequard), a fact which goes to 

 account for the increase of fibrine in inflammation when the liver 

 is inactive. The change consists mainly in deoxidation and 

 reduction into .simpler compounds which can be more readily 

 dissolved and eliminated. Arrest of the liver functions in fever 

 is therefore liable to throw into the blood, products that are little 

 soluble and often poisonous. The end product is largely urea, 

 and this Cyou always found in excess in the hepatic veins of dogs 

 (in the portal veins 0.08 grammes, and in the hepatic veins 0.14 

 to 0.17 grammes). In man hepatic disorder is at once marked by 

 the lessening or disappearance of urea from the urine, and the 

 increase of the less oxidized uric acid (Parkes). In acute atrophy 

 of the liver, urea disappears from the urine, being replaced by the 

 less oxidized leucin and tyrosiu (Frerichs, Murchison). In birds 

 urea is replaced by uric acid and this is always found in the liver. 



The increase of urea and allied products bears a direct relation 

 to the activity of the hepatic circulation. Stimulation of the 

 liver by electric current sent through the abdominal walls largely 

 increased the secretion of urea (Sigrist, Stolnikow, Schroder and 

 Salomon). Murchison, Perrin and Bruardel had a great increase 

 of urea by stimulating the circulation in the liver. Certain agents 

 ingested are transformed into urea, among which may be named 

 glycocolle, brucin, asparagine, sarcine, alaunine, and ammonia 

 muriate. 



Any degeneration of the hepatic cells which impairs or arrests 

 their functions lessens the production of urea. In fevers there- 

 fore and in hepatic degenerations the extent of the functional or 

 structural derangement may be to a large extent gauged by the 

 diminution of urea. A simple hyperaemia, without as yet any 

 seribus impairment of structure or function, may be attended by 

 a marked increase of urea, whereas any destruction of the liver 

 cells, or any serious modification which interferes with the normal 

 function, brings about a decided decrease. A hepatic disorder 

 410 



