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

Ammonimmia. 821a of the kidneys, lead either to ammon"nemia or nramia.A painful anuria, sometimes relieved by copious dischargesof bloody urine, pain and swelling in one or bothsides of the abdomen indicate the primitive cause. If thereis a concretion, the ureter becomes dilated above and aroundit, the walls are pushed outward, and the room thus madeallows the urine to pass until the stone, pressed downwardsis again wedged in. Even large concretions may, in thisway, reach the bladder, and as long as the other kidney isnot disturbed in its functions, there is not much danger..V continued stagnation of the urine in the pelvis of thekidney may, however, result in decomposition and resorption; that is, ammoniaemia. Of course, death may ensuewithout that—for instance, as a consequence of anuria anduremia in 6bl iterationof the ureter.Tuberculosis of the kidneys is also one of the excitingcauses of ammoniremia. How far abscesses of the same,ns may have the same effect, cannot be at present ascertained,besause they were complicated with diseases ofthe bladder, wherever observed with the disease in question.The kidneys may be destroyed by extensive ulceration,ending in death, without one symptom of ammoniaemia.Cancer of the kidneys is also not likely to produceit.Another form of ammonimmia, distinguished by a veryrapid course, arises from the decomposed urine penetratinginto normal tissues. This may happen, for instance, intothe cellular tissue of the peritoneum, by ulcerative ruptureoi* the urethra, or into the tissue of the abdominal wallsafter puncture of the bladder, when the urine was in a statelecomposition in consequence of previous dise;There are violent pains, frequent chills, vomiting and frequentdiarrhea, ending in sopor and death.The senile vesical torpor developes itself, without anydemonstrable morbid affection of the bladder or urethra, inpersona about, or beyond the age of fifty. The circumstancesinfluencing its appearance and development, are notalways easily determined. It is only certain that this torpor.iher from insuiheient innervation or from retrometamorphoHfland fatty degeneration of the fibreslie detrusor muscle. Patients afHicted with this troublecannot pas< their uri ept with strong abdominal pressure,and then only in a short and interrupted stream. Acomplete evacuation of the bladder, if it can be effected at