INTRODUCTORY REMARKS ON THE STRUCTURE AND FUNCTIONS Function of the kidney-Medullary and cortical substance-Medullary pyramids- Blood-vessels of the kidney-Malpighian tufts-Tubules-Epithelium-Lymph SYMPTOMS, PATHOLOGY, AND TREATMENT OF ALBUMINURIA. Symptoms of anæmia-Effect of deficiency of blood-Pallor-Muscular weakness— Shortness of breath-Dyspepsia-Edema-Palpitation-Causes of anæmia- Anæmia from albuminuria-Symptoms of albuminuria-Tests for albumin- Fallacies-Structure of the kidney-Size of molecules-Diffusion-Size of hæmoglobin molecule-Forms of albumin-Their molecular size-Arteries and veins-Cardiac disease and albuminuria-Venous congestion-Indications for True and false albuminuria-Effect of alterations in arterial and venous circulation on albuminuria—Renal congestion-Structure of the kidney-Relation between the quantity of the urine and the proportion of albumin-Effect of meat, fat, and time of day on the proportion of albumin-Albuminuria from imperfect Nature of dropsy-Experiments on cedema-Short-haired and long-haired dogs- Use of water in the organism-Excretion of water-The skin as a regulator of temperature-Relationship between the skin and kidney-Threefold function of the kidney-Absorption in the urinary tubules-Blood-supply of the glomeruli and tubules-Factors in the secretion of urine-Vascular supply of the kidney -Nervous supply of the kidney-Blood-pressure in urinary secretion-Erythro- phlocum-Digitalis-Modes of action of diuretics-Uses of diuretics-Hot water PHYSIOLOGICAL RESEARCHES ON THE NATURE OF CHOLERA Sept. 1873 ON THE ACTION OF PURGATIVE MEDICINES ... May and June 1874 ATROPIA AS AN ANTIDOTE TO POISONOUS MUSHROOMS ... Nov. 1874 THE PHYSIOLOGICAL ACTION OF ALCOHOL ... ... ... Jan. and Feb. 1876 Sept. 1876 ON THE ACTION OF ALTERATIVES INDIGESTION AS A CAUSE OF NERVOUS DEPRESSION Oct. and Nov. 1880 INTRODUCTORY REMARKS ON THE STRUCTURE AND FUNCTION ON POISONS FORMED FROM FOOD, AND THEIR RELATION TO BILIOUSNESS AND DIARRHEA ... Aug., Sept., and Oct. 1885 Delivered before the Medical Society of London, January 5th, 1885. MR. PRESIDENT AND GENTLEMEN,-I thank you most sincerely for the honour you have done me in appointing me to deliver the Lettsomian Lectures before you this year. The subject I have chosen is one of much practical interest, but it is of such extent that, to deal with it completely, in a course of three lectures, is obviously impossible. I have already discussed the physiological processes of digestion at considerable length elsewhere,1 and I have therefore less hesitation in passing over those which are well known, with a few general remarks, and dwelling at greater length upon some points which are not so fully described in textbooks, although they have important bearings on the practice of medicine. Man has been defined as a cooking animal. This definition may not be absolutely correct, and there may be some of the lowest. races unacquainted with methods of cooking, although other characteristics entitle them to be called men. Yet the definition is, in the main, true, and the fact that man cooks his food, while the lower animals eat theirs raw, is one of the most marked distinctions 1 Digestion and Secretion, forming Part III. of Sanderson's Handbook for the Physiological Laboratory, 1873. London: Churchill. With the assistance of Dr. D'Arcy Power I have revised it for the French translation by Professor Moquin Tandon, 1884. Paris: Felix Alcan. B between him and them. The practice of cooking was familiar to man at a very early stage, indeed, of his history. Long, long before the historic epoch, when man's only implements consisted of broken flints, he cooked his food by roasting, and the charred remains of bones, which he had roasted in order to enjoy the savoury marrow, have been found in caves, along with fragments of the skeletons of the cave-bear, woolly rhinoceros, and other animals long ago extinct. There is little doubt that roasting was the first method of cooking adopted, for no implements were required, beyond a piece of pointed stick, to hold the food in front of the fire. Boiling is a considerably more complex process, and requires a vessel in which to hold water. This vessel need not necessarily stand fire, because the simplest method of boiling, and the one which was probably first adopted, appears to be that of heating the water by putting red-hot stones into it, until the temperature is sufficiently raised. But after man learned to make pottery, and to bake it in the fire, so that heat could be applied from the outside without the vessel cracking, the simpler plan of boiling the water by putting the earthen pot upon the fire, would be sure to be followed; for man, as a rule, likes to save himself trouble, and usually takes what seems to him to be the easiest plan. Other pots we sce handled with the Yet both vessels Amongst the various pots of earthenware, early man must have noted the same differences that we do now. We see some pots of thoroughly baked earthenware so hard and strong as to resemble stone; and, indeed, in the case of a Wedgwood mortar, the earthenware is more resistant than almost any stone. of fine china, thin and fragile, which must be greatest care, lest they break under our fingers. are equally whole. Turn them round and round, and scan them most minutely, and yet you will find no flaw in either the one or the other. There is no difference between their wholeness, or wholth, or, as we now write it, health; yet the wholeness or health of one vessel is strong, and the wholeness or health of the other is weak. The one may be put to all sorts of purposes, subjected to all sorts of treatment, meet with all sorts of rough usage, and yet it will remain whole or healthy. The other remains whole only so long as it is treated with the greatest care; the slightest rough usage will crack or break it, and then its wholeness or health is gone. Our early forefathers, when framing a language by which to communicate with one another, had evidently been struck by an |