Thus Mayer* found that when the two kidneys were extirpated in the guinea-pig, the cavities of the peritoneum and the pleura, the ventricles of the brain, the stomach, and the intestinal canal, contained a brownish li quid having the odour of urine ; that the tears exhaled the same odour ; that the gall-bladder contained a brownish liquid not resembling bile ; and that the testicles, the epididymis, the vasa deferentia, and the vesiculm semi nales, were gorged with a liquid perfectly si milar to urine. Chirac and Helvetius are quoted by Haller as having tied the renal ar teries in dogs, and having then remarked that a urinous fluid was passed off' from the sto mach by vomiting. A remarkable case is quoted by Nysten from Zeviani, in which a youno. woman having received an incised wound on the external genitals, which would not heal, the urine gradually became more scanty, and at last none could be passed even with the assistance of the catheter ; at last dropsy supervened, with sweats of a urinous odour, and vomiting of a urinous fluid, which continued daily for thirty-three years. On post-mortem examination, the kidneys were found disorganised, the right ureter entirely obliterated and the left nearly so, and the bladder contracted to the size of a pigeon's egg. In some other instances, the urine ap pears to have been secreted, and then re-ab sorbed in consequence of some obstruction to its exit through the urinary passages. Thus Nysten quotes from Wrisberg a case in which, the urethra having been partially obstructed for ten years by an enlarged prostate, the bladder was so distended as to contain ten pounds of urine ; and the serosity of the pericardium and of the vesicles of the brain exhaled a urinous odour. He cites other in stances in which the presence of calculi in the bladder prevented the due discharge of the secretion ; and in which a urinous liquid was ejected from the stomach by vomiting, or was discharged by stool. A still more remarkable case is recorded, of a girl born without either anus or external genitals, who nevertheless remained in good health to the age of fifteen years, passing her urine from the nipples, and getting rid of fmcal matters by vomiting. There are cases, moreover, in which it would seem that the mucous lining of the urinary bladder must have had a special power of secreting urine ; the usual discharge having taken place to the end of life, when, as ap peared by post-mortem examination, the kid neys were so completely disorganised that they could not have furnished it ; or, having been prevented by original malformation, or by ligature of the urethra, from discharging it into the bladder. A considerable number of these have been collected by Burdach.* In all the older statements of this kind, there is a defi ciency of evidence that the fluids were really urinous, urea not having been obtained from them by chemical analysis, and the smell having been chiefly relied upon. The urinous odour, however, when distinct, is probably nearly as good an indication of the presence of the most characteristic constituent of hu man urine, as is the sight of the urea in its separated form. The passage of a urinous fluid from the skin has been frequently ob served in cases in which the renal secretion was scanty ; and the critical sweats, by which attacks of gout sometimes terminate, contain urates and phosphates in such abundance as to form a powdery deposit on the surface. It has lately been ascertained, that in warm climates urea is an element of the perspiration even of healthy persons.t The metastasis of the biliary secretion is farniliar to every practitioner, as being the change on which jaundice is dependent. It is not, however, in every case of yellowish brown discolouration of' the tissues, that we are to impute such discolouration to the pre sence of biliary matter ; and we can only safely do so, when we have at the same time evidence of concurrent disturbance of the biliary apparatus. This disturbance may be of two kinds : either the secreting function of the liver itself may be diminished or sus pended, so that the original elements of bile accumulate in the blood; or, the secretion being formed by it as usual, its discharge may be prevented by obstruction of the gall-ducts, so that it is re-absorbed into the blood. The former condition is much the most dangerous of the two ; the re-absorption of the secretion after it has been once eliminated not being nearly as injurious as the cessation of the eliminating process. In either case, the uri nary' apparatus is the principal channel through which the biliary matter is eliminated ; the urine becomes tinged with the colouring prin ciple of bile, beinn. sometimes of a yellowish or orange hue, and sometimes of a brown co lour with a considerable sediment ; and the presence of the most characteristic consti tuents of the bile has been determined in the urine. The same result presents itself when the biliary duct has been artificially obstructed by ligature. Other secretions have been found tinged with the colouring matter of bile : thus the pancreatic fluid has been seen of a yellow colour in jaundice; and the milk has presented not merely the hue, but the characteristic bitterness, of the biliary secre tion. The cutaneous transpiration is not un frequently so much impregnated with biliary matter, as to communicate the tinge to the linen covering the skin ; and even the sputa of patients atTected with bilious fevers have been observed to be similarly coloured, and have been found to contain biliary matter.
The secretions of serous membranes, also, have been fiequently seen to present the cha racteristic hue of bile ; and biliary matter has been detected, by analysis, in the fluid of the pleural and peritoneal cavities.
Biliary matter, however, when unduly pre sent in the circulating current, is not removed from it by the secreting organs alone; for it seems to be withdrawn also in the ordinary operations of nutrition, entering into combi nation with the solid tissues. Thus, in per sons affected with jaundice, we find the skin, the rnucous and serous membranes, the lym phatic glands, the brain, the fibrous tissues, the cartilages, the bones and teeth, and even the hair, penetrated with the colouring mat ter of the bile, which they must have with drawn from the blood, and which seems to have a particular affinity for the gelatinous tissues.
Many instances are on record, in which the secretion of milk has apparently been trans ferred from the mammary glands to some other surface. It might be expected, florn what has been already stated regarding kies tine, that the kidneys should eliminate the constituents of the secretion when the mam mary glands are unable to do so. Several cases in which this happened are referred to by Voigtel.* One of these, strange to say, was a male, who was suffering under tume faction of the mammary glands, accompanying an attack of catarrh. It is well known that the secretion of milk may be formed by the mammary gland of the male under particular circumstances ; but it could scarcely have been anticipated that it would be produced and eliminated through any other channel. A case has been recorded by Koller, however, in which this was unequivocally the case. A young man, suffering under various ailments, was affected with a vesicular eruption on the skin of the scrotum, which was considerably distended, and on the thighs ; and these ve sicles discharged a large quantity of a whitish fluid, of somewhat spermatic odour, in which Lihvig detected butter, caseous matter, sugar of milk, and alkaline and earthy salts. A fluid, having the appearance of milk, has also been transuded from the skin of the umbi licus, of the axillm, of the groins, and of the -back ; from the gastro-intestinal mucous membrane ; from the mucous membrane of the genitals ; and from the surface of an nicer. The following seems an unequivocal case of the vicarious secretion of milk by a very unusual channel.
" A lady of delicate constitution (with a predisposition to pneumonia) was prevented from suckling her first child, as she desired, by the following circumstance. Soon after her delivery she had a severe fever, during which her breasts became very large and hard ; the nipples were swollen and firm ; and there was evidently an abundant secretion of milk ; but neither the sucking of the infant, nor any artificial means, could draw a single drop of fluid from the swollen glands. It was clear that the milk-tubcs were closed ;'• and as the breasts continued to grow larger and more painful, purgatives and other means were em ployed to check the secretion of milk. After three days the fever somewhat diminished, and was replaced by a constant cough, which was at first dry, but soon after was followed by the expectoration of simple mucus. After this the cough diminished in severity, and the expectoration became easy ; but the sputa were no longer mucous, but were composed of a liquid which had all the physical charac ters of genuine milk. This continued for fifteen days, the quantity of milk expectorated amounting to three ounces or more in the twenty-four hours. The breasts gradually diminished in size ; and by the time that the expectoration ceased, they had regained their natural dimensions. The same complete ob stacle to the flow of milk from the nipples re curred after the births of four children suc cessively, with the same sequel. After the sixth, she had the same symptoms of fever, but this time they were not followed by bron chitis, or the expectoration of milk ; she had in their stead copious sweatings, which, with other severe symptoms, reduced her to a cachectic state, and terminated fatally in a fort n ight."* Although the menstrual flux cannot be re garded in the light of an ordinary secretion, since it consists in great part of actual blood, yet there are indications that it is the means of removing from the body something that is more injurious to it than a mere superfluity of the circulating fluid. A sudden suppression of the catamenia is frequently followed by symp toms of constitutional disturbance, which neither general nor local abstraction of blood suffices to relieve, and which are only abated by tne restoration of the uterine flux, or by the establishment of a similar discharge from some other organ. Hence cases of vicarious menstruation may really be placed on the same footing with those of metastasis of secretion ; and they serve to illustrate and establish the same general truth. Such cases are by no means uncommon, the menstrual flux being replaced by hmmorrhages from various parts of the skin, from the mucous membranes, or from glandular surfaces, especially the mammw. The following case, quoted by M. Brierre de Boismont* from the " Medecine Pratique" of Pinel, is of peculiar interest from the variety of phenomena which it presents.