Issue 10, pp. 753-832, October 1861, SMSJ

'1861.] vmxmksmia. 819composition of the stagnant urine, and its resorption, ft isevident that the decomposition must be hastened by the presence,in the bladder, or catarrhons secretions, blood, or productsof exsudation. At this stage of the disease, the urine,he it evacuated spontaneously or artificially, presents a pungent,often distinctly anmioniacal odor, ana a mucous or purulentsediment, sometimes mixed with blood. Wherever anammoniacal odor is perceivable in recently-voided urine, wemay pretty certainly diagnosticate ammomsemia.3. The carbonate of ammonia is eliminated through the?lungs and skin soon after its reception into the hlood ;this isproved by the distinct ammoniacal odor of the expired air.and other exhalations. Where this odor is not very distinct,the expired air may be tested with humid litmus-paper, orwith a stick of glass, previously immersed in muriatic acid.The chemical analysis of the hlood would, undoubtedly, furnishthe best basis for a correct diagnosis; but the patientsafflicted with ammoimemia are always in a state which doesnot admit of the depletion of blood.•i. Gastric symptoms, as already described, are always present.The evacuations in acute cases do not, at least not inthe first time, present a distinct ammoniacal odor; but this \-always well marked, when emesis and catharsis appear withan aggravation of the disease. In chronic ammoniaunia theremay be neither vomiting nor diarrhoea, but rather a tendencyto constipation : the appetite is, however, with very rare exceptions,disturbed, and a marked aversion to meat present,such as is not observed in any other disease, even not exceptingcancer of the stomach. Other gastric symptoms, for instance,a sensation of dull pressure or burning pain in theach, accumulation of gases, bad taste, furred tongue, etc.,are not characteristic of ammonisemia. But the dry conditionof the month and fauces is important, and may often lead tothe diagnosis when other prominent symptoms are wanting.The discoloration of the face, the emaciation and collapsethe features, finally the continuous depression of spirits, whichis frequently explained as hypochondriacal, will serve toconfirm the diagnosis. The effect on the mind of the patientmay grow >trnir enough to induce the committing of suicide.In the treatment, stricture- of the urethra, which are frequentlypresent, mnst be removed, and the urine regularlyevacuated by means of the catheter. Milk diet, residence inthe country, generous exercise in the fresh air. are often sufficient,in addition to these mean-, to restore the patient.Daring recovery, a vigorous diet is required, which may bo