28 
JOHN R. HART. 
the destruction of cells, disassimilation of secretions, indigestion 
and putrefaction. The digestive canal contains these poisons. 
Those which come from the ingesta, bile, and putrid material,, 
therefore, should be toxic. Experimentation has demonstrated 
that they are toxic from the potash and ammonia, toxic from 
bile and putrid material. While you cannot demonstrate exper¬ 
imentally that the poison enters the blood, you can demonstrate 
that it leaves the blood. When bile ceases to flow into the in¬ 
testines it passes into the blood. This problem is in doubt. Any 
alteration in the liver caused by disease will prevent the excre¬ 
tion of effete material. Now, if such is the case, where will this 
effete material go ? Or will nature allow it to so flow, or be 
taken up by some channel whereby the blood will not become 
contaminated with this injurious material ? It has been shown 
that it does not. The result is that the effete material collects- 
in the blood. With wh?it results? To act as powerful irri¬ 
tants in the animal circulation. This material first prevents the 
proper flow of the blood; second, causes a complete stasis 
third, a dilatation of blood-vessels ; fourth, a direct pressure upon 
the nerves; fifth, a complete loss of power from pressure on the 
nerves ; sixth, decomposition to follow. 
In my paper on azoturia in 1883, I stated that azoturia was 
purely a liver and kidney disease. At the present date I feel 
more than convinced that azoturia is purely of this nature. The 
question may be asked why should the kidney be a factor in 
this disease of the liver? I answer, in conjunction with the 
paralysis by dilation of the renal arteries, caused by the effete 
material circulating in the blood. 
Guitaris says, that any agent to cause an obstruction of the 
circulation or nervous influence may act by trophic derange¬ 
ment by causing circulatory disturbance, vaso motor action, the 
necrosed part may be absorbed, retained, or discharged. We 
have general excess of blood where there is a plethoric condi¬ 
tion, a true hypersemia, and with this we have nervous influ¬ 
ence. This may be due to paralysis of the vaso-constrictors, 
whereas the outflow of blood is prevented. 
