A'ZOTUKTA 
519 
but are made without reason, though not without rhyme, as they 
are usually rhythmical in character. Later on in azoturia we have, 
however, similar convulsive efforts. 
From blind staggers it may be diagnosed by the difference in 
situation. Blind staggers, probably anthracoid in character, is only 
seen in animals pastured on low rich bottomed meadows in sum¬ 
mer time; azoturia is usually a disease of winter and of the stabled 
animal. 
Causation .—Azoturia is a disease of the functions of nutrition— 
a disease of nutritious excess. It is a disease of the well-to-do 
man’s horse. 
One of the conditions of health is that the excess of nutrition 
be removed by the lymphatics. It is conveyed again to the right 
side of the heart along the thoracic duct, and again poured into 
the current of the circulation to nourish the tissues. In azoturia 
there is so great nutritive excess that a large portion of nutritive 
matter is thrown back, undergoes retrograde decomposition into 
urea or the analogues of urea, and acts as a poisonous substance 
on the nerve centers. Centrally, it is probably a failure of the 
liver to perform its scavenger-like function of burning up the 
waste proteids. What I wish especially to call your attention to, 
however, is, that whatever its exciting cause, azoturia is urcemia. 
You have to deal with imemie poisoning, and whether this is 
caused, as in this case, by the inaction of a surplus of nutrition 
on a healthy hard-working organism, or is due to inability of the 
kidneys to separate retrograde material from the blood, matters 
little as regards your treatment. 
The question may be asked, why is azoturia more common in 
mares than horses. I think the question admits of ready answer. 
The female organism is, so to speak, more conservative than the 
male. Intended by nature to care for and support her parasitic 
offspring, she lays up with greater readiness than does the male a 
supply of nutritive matter in excess of her own requirement, and 
I think this part of my explanation is strengthened by the fact 
that mares in foal rarely have azoturia. 
Secondly, the function of reflex irritation is higher in mares 
than in horses. Dr. Zuill, of Philadelphia, informs us that he 
