Uremia. 983 



develop in the brain. — Bouchard & Lepine found that the normal urine has toxic 

 properties which are considerably diminished in uremia because toxie substances 

 which are ordinarily eliminated are retained in the blood. — ^According to Brown- 

 Sequard the kidneys are, similar to other organs, believed to produce certain 

 substances, by the agency of an internal secretion, which are necessary for tha 

 normal maintenance of organic functions; the absence of such substances would 

 then furnish the foundation for uremia. 



In an acute form uremia is not observed very frequently 

 in animals, but chronic uremia is by no means rare, especially 

 in dogs, and gives rise to less striking disturbances, wbicb 

 also admit of a different explanation. 



Symptoms. Acute uremia occurs especially as a sequel 

 of severe acute, and sometimes also of chronic kidney disease, 

 also in consequence of complete retention of urine if the func- 

 tion of the kidneys has been interfered with to a considerable 

 degree within a brief space of time. As a constant symptom 

 there occurs stupor, sometimes preceded by staggering and 

 vertigo and usually increasing to somnolence and to complete 

 unconsciousness. Simultaneously the animals often show 

 trembling or even clonic contractions, which are often limited 

 to single muscles or groups of muscles ; these are soon followed 

 by general epileptiform convulsions (Pflug observed opis- 

 thotonus in a cow), and on their cessation consciousness does 

 not return, but the animals remain prostrate and unconscious. 

 There are, however, isolated cases in which consciousness is 

 preserved even during the convulsive attacks (Lienaux), and 

 in some cases symptoms of excitement are observed between 

 times. 



Respiration is sometimes retarded (owing to the uncon- 

 sciousness) and sometimes rendered difficult owing to the 

 edema of the lungs which develops ; occasionally Cheyne-Stokes ' 

 respiration is observed. The temperature may at first be con- 

 siderably increased, but in the stage of stupor it falls even 

 below normal. Sometimes strong perspiration is observed and 

 the skin emanations as well as the exhaled air disseminate a 

 urinous odor (especially after rupture of the bladder). 



The digestive troubles are manifested in inappetence, sup- 

 pression of rumination, in carnivora also in vomiting, and in 

 all species by diarrhea. (The last symptoms are attributed 

 to disintegration products of urea which are eliminated through 

 the intestinal mucosa and cause inflamination.) The vomited 

 material sometimes also has an odor of urine. 



Acute uremia either causes death in a short time, the fatal 

 termination sometimes occurring after the first convulsive at- 

 tack, or it is postponed for several days during which the 

 paroxysms are repeated in longer or shorter periods. In 

 animals acute uremia has hitherto always had a fatal termina- 

 tion with the exception of a case of the authors, in a horse 

 with retention of urine, in which relief of the retention caused 

 the uremic symptoms to disappear after a short time, 



