32 
JOHN R. HART. 
tions. An increase in muscular exercise leads to an increase in 
the elimination of urea, as the amount of kreatin formed by the 
muscles increases with exercise, and as the amount of urea elim¬ 
inated by the kidneys increases under the same circumstances it 
would appear reasonable to assume that the kreatin resulting 
from the breaking down of the albuminous tissue constituents of 
muscles and nerves represent the main source of urea. The sup¬ 
pression of urine is followed by the aceumulation in the system 
of a large amount of urea. Again, the urea under all circum¬ 
stances in this disease becomes a constituent of the blood. An¬ 
other source of urea may be found in the products of decompo¬ 
sition of albuminous matter in the intestine. The introduction 
of a large amount of proteid in the alimentary canal is followed 
by a corresponding increase in the amount of urea eliminated. 
An excess of proteid over and above that needed for nutrition in 
the alimentary canal breaks down under the influence of pancre¬ 
atic digestion into leucin and tyrosin. If leucin be itself intro¬ 
duced into the intestinal tubes the amount of urea eliminated 
will be proportionately increased. Leucin, therefore, may rep¬ 
resent a step in the process of conversion of albumen into urea. 
In the latter case we ean probably locate the conversion of leu¬ 
cin into urea in the liver, for the liver, unlike other glands, nor¬ 
mally contains large quantities of urea. We can assume, per¬ 
haps, that leucin is absorbed by the portal vein, hence the 
formation of urea out of leucin would be a natural conclusion. 
This evidently shows the relation between the liver and the 
kidney in the disease of azoturia. 
{To be continued.') 
Sanmetto in Azoturia.— I. W. Horton, M. D. C., of 
Providence, R. I., writing, says : “I used Sanmetto in a very 
severe case of azoturia. The horse had been down for forty- 
eight hours, and within three days I had him on his feet, and at 
the end of five days the horse was at work. In my opinion San¬ 
metto is a grand medicine for azoturia. I shall keep it on hand 
in my hospital.” 
