neumonia, that from heart disease; in the days of Broussais
this would have sounded absurd, but, to-day, some forms of heart disease
are known to be the regular sequences of some particular form of kidney
disease, just as some form of pneumonia attends an affected heart and
that some forms of pneumonia degenerate into phthisis. When the blood
change is an established fact, it is only a question as to which is the
weak organ, and the organism of the individual will decide whether it
will be a simple sick-headache or the beginning of a pneumonia ending in
phthisis.

I have purposely dwelt on this part of this subject, owing to the recent
origin and publication of many of the views connected with it; also on
account of the greater ease of making the subject plain by fully
discussing each step of the process; and if the views of Sir Lionel will
be recalled, that a toxic element in the blood is the starting-point,
and that an irritable or weakened organ invites destruction,--the
induction of serious and fatal kidney disorder by the transmitted
irritability and consequent injury to the kidney produced by preputial
irritation in the first instance, and the supplemental blood-poisoning
by intestinal absorption of septic matter, which soon brings about Sir
Andrew Clarke's "inadequacy of kidney,"--all will be readily understood.
When this point is reached, a too hearty meal, exposure to variable
weather, or a little extra care or anxiety, are sufficient, as
determining causes, to bring life into danger.

As pointed out, many cases of Bright's disease or other renal difficulty
have their origin in this distant but visible source, and, although
malarial poisoning and a great number of other causes will produce the
same particular organic changes and diseases, this condition must be
admitted as one of the frequent causes. The influence of the
genito-urinary tract on the rest of the economy, and the importance of
the sympathy it excites, or how quickly, by its being irritated, some
apparently dormant pathological condition will be awakened to life and
activity, is not sufficiently appreciated. As observed by Hutchinson, a
patient who has once been the subject of intermittent fever is more
prone, on catheterization, to have a urethral chill and fever than one
who had never had the fever. (Hutchinson: "Pedigree of Diseases.")

Ralfe observes, in his "Kidney Diseases," that long-standing disease of
the genito-urinary passages must be