In gout: Arrest of oxidation of proteids into urea. Deposits of
biurate of lime on joints, and other disorders. Urinary calculi
containing urates, cystine, xanthine, etc., also from imperfect
oxidation of albuminoids. Oxalic acid represents a similar arrest.
Kidney degenerations from irritating urates and oxalates. Fatty kidney
from excessive glycogenesis. Digestive disorders from excess or
deficiency of bile or torpid liver. Nervous disorders, dullness,
lameness, vertigo, spasms, irritability from hepatic inactivity and
resulting poisons. Sore throat and bronchitis from hepatic
derangement. Skin eruptions in tardy or imperfect action of the liver.
Treatment: Abundant water, succulent vegetables, ensilage, fresh
grains, balanced ration, in carnivora and omnivora oat meal,
buttermilk, clear meat juice, avoid sweets, gravies, spiced animal
food. Dangers for pampered horses, dogs, and old improved meat
producing animals. Open air exercise. Laxatives with alkalies,
salines, mercurous and mercuric chloride, pilocarpin, chlorides,
iodides, bromides, nitro-muriatic acid, ipecacuan, euonymus, bitters.
Among the many secondary results of hepatic disorder, and which are
habitually described as affections of other organs a few may be
mentioned as indicating the wide range of influence exercised by the
liver in disease as well as in health.
_Gout_ as it appears in fowls and omnivora is directly due to the arrest
of the transformation of the albuminoids into urea. Circulating in the
system in the form of the less perfectly oxidized and less soluble uric
acid, it determines deposits of biurate of lime around the joints, with
local inflammations, and disorders of circulation and innervation, and
altered spirit, temper, etc.
_Urinary calculi_ in the same animals, are composed largely of urate of
lime, cystine, xanthine and other nitrogenous products representing
various stages of oxidation short of the final transition into urea and
ammonia. Recognizing the active rôle which the urinary bacteria fill in
this respect we must still acknowledge the great importance, as
causative agents, of an excess in the urine of these comparatively
insoluble products.
The oxalic acid found in certain calculi points in the same direction,
as this acid, both in the body and in the laboratory, is found to result
from the oxidation of uric acid (Wohler, Schenck, Hutchinson).
_Degenerations of the Kidneys_ are to be largely traced to the same
hepatic source. The uric acid diathesis, and the oxalic acid diathesis,
both the result of imperfect liver function, are among the most frequent
causes of irritation of the kidneys, by which channel they are
eliminated from the body. Hence acute and chronic nephritis, as well as
nephritic calculi result from morbid conditions which have their
starting point in the imperfect function of the liver. Again fatty
degeneration of the kidney is very liable to result from derangement of
the glycogenic function of the liver, the tendency to the formation of
fat and the constant irritation caused by the passage of the sugar
contributing to the tissue degradation. In such cases albuminuria is a
not uncommon accompaniment.
_Derangements of the Digestive Organs_ may be said to be a necessary
result of hepatic disorder. Excessive secretion of bile stimulates
peristalsis and may induce diarrhœa, while diminished secretion tends to
constipation, light colored, fœtid stools, intestinal fermentations and
poisoning by the irritant products. A torpid hepatic circulation means
congestion of the whole portal system, indigestions, colics, chronic
muco-enteritis, intestinal hemorrhages, hemorrhoids, etc.
_Derangements of the Nervous System._ In this connection may be named
the lameness of the right shoulder which accompanies certain disorders
of the liver, the extreme dullness and depression that attends on
others, the sluggish pulse that appears in certain types, the
unsteadiness of gait (giddiness) in others, the muscular cramps, and
irritability in still others. These appear to be due in some instances
to the nervous sympathy of one part with another, whilst at other times
they as manifestly depend on the circulation in the blood of partially
oxidized and other morbid products of hepatic disorder which prove
direct poisons to the nervous system.
Derangements of the circulation, like extreme rapidity, or slowness of
the pulse, irregularities in rhythm and intermissions, may be charged
more directly on the nervous affection, though primarily determined by
hepatic disorder.
On the part of the _Respiratory Organs_, affections of a chronic type,
like sore throat and bronchitis may often be traced to hepatic torpor or
disorder.
_Skin Diseases_ are notoriously liable to come from inactive or
disordered liver, the irritant products circulating in the skin or
sweating out through it, giving rise to more or less irritation. The
result may be a simple pruritus, an urticaria, an eruption of papules,
vesicles or even pustules. In any such cases it is proper to look for
other indications of liver disease,—pale color and offensive odor of the
fæces, muco-enteritis, indigestion, icterus or yellow patches on the
mucous membranes, tenderness on percussion over the asternal ribs,
muscular neuralgia, nervous disorder, the passage of bile, hæmoglobin,
albumen, sugar or other abnormal elements in the urine, etc.