ght's disease being one of the most
common. As observed by Fothergill, however, the kidney is not the
starting-point, the new departure only taking place when the structural
change on the kidney has reached that point that it is no longer equal
to its function--the "renal inadequacy" of Sir Andrew Clarke. (J. Milner
Fothergill, in the _Satellite_, February, 1889.)

During the Bradshawe lecture, Dr. William Carter made the following
remarks: "According to Bonchard, one-fifth of the total toxicity of
normal urines is due to the poisonous products re-absorbed into the
blood from the intestines, and resulting from putrefactive changes which
the residue of the food undergoes there." In the course of the lecture,
Dr. Carter fully explains that one of the benefits derived from milk
diet in Bright's disease is the small residuum deficient in toxic
properties, and lays great stress on the employment of intestinal
disinfectants or antiseptics that exercise their influence throughout
the whole tract, suggesting naphthalin as peculiarly efficacious,
thereby cutting off one source of blood contamination at its source.
Although these are recent developments in medicine, Bonchard mentions
that in the practice of M. Tapret cases treated on this principle did
well. (Braithwaite's _Retrospect_, January, 1889.)

Persons laboring under this toxic condition of the blood, with a
consequent deterioration in the texture and the physiological function
of the vital organs, are of that class that easily succumb to injuries
or serious sickness, and of that class to whom a surgical operation of
even medium magnitude is equal to a death-warrant.

The above conditions are an almost constant attendant on that condition
of the sphincter described by Agnew as sphincterismus, which also is
productive of haemorrhoids and fissure, and often of fistula. That
sphincterismus is caused in many cases by preputial irritation is as
evident as that the same affection, or haemorrhoids or any other rectal
or anal affection, will, in its turn, produce vesical and urethral
reflex actions, and primarily functional and secondarily organic changes
in those parts. Besides, the great number of cases wherein the gradual
and progressive march of each pathological event could be traced with
accuracy has convinced me of the true cause of the difficulty being the
result of reflex irritation.

Delafield, in his "Studies in Pathological Anatomy," gives, as the first
form of p