26 
JOHN R. HART. 
As for the biliary salts, they do not kill by direct intoxica¬ 
tion alone; they dissolve and break up blood globules and also 
other cells, striated muscular fibres and cells of the liver. 
They, therefore, cause anatomical lesions, and intoxication 
arises from the setting free of toxic substances, which enter into 
the composition of the cellular elements. This intoxication 
develops but slowly ; so long as there is functional activity of 
the kidneys, all is well, but if this activity ceases then death 
might result by the potash and other products of cellular de¬ 
struction. It is said that if all the bile which the liver secretes 
passed directly into the blood man would be poisoned by his 
own bile in eight hours. If all the urine that the kidneys se¬ 
crete passed directly into the blood, man would be poisoned by 
his own urine in two days. We see the danger which results 
either from an impediment in the way of the elimination of 
bile or from its absorption. Fortunately more than one-half is 
eliminated in twenty-four hours by the digestive canal. What 
becomes, then, of the half of the bile which is not thrown out 
by the digestive canal ? Does the liver destroy it ? Do the tis¬ 
sues change it ? These two hypotheses are possible, but are 
not demonstrated. What is demonstrated, is that in the intes¬ 
tine a portion of the bile ceases to be absorbable. The coloring 
matter and the biliary salts are metamorphosed, precipitated, or 
rendered insoluble ; yet in certain morbid conditions bile may 
be absorbed in the liver itself at the margin of the hepatic 
cells. In these cases, if the kidneys lemain permeable, it be- 
.comes a menace to intoxication ; if they have ceased to be so, 
poisoning is the result. 
The above facts lead to the conclusion that when, from a 
faulty liver, we can have, aside from liver and kidney, a third 
source of poison for the blood, as we do in this disease of azotu- 
ria (that is, putrefaction), not only that which arises from the 
imperfectly digested matter, but that which the presence of mi¬ 
cro-organisms in the intestinal tube incessantly maintains in the 
digestive canal the conditions most favorable for the elaboration 
.of poisons are realized. Therein are found nitrogenous sub- 
