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June 27, 1891


JAMA. 1891;XVI(26):918-919. doi:10.1001/jama.1891.02410780018003

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There is no more obscure subject in pathology, than the various clinical phenomena grouped under the general head of uræmia. Of all the theories that have been advanced, it must be confessed that none of them offer a complete explanation of its varying conditions.

For years the most generally accepted doctrine, and one that contributed the name to this symptom complex, regarded it as simply due to an excess of urea in the blood; this view was then followed by that of Frerich's, who taught that carbonate of ammonia was the toxic substance. Further observations gave the coup de grace to these earlier views, and apparently demonstrated that various excrementitious substances such as xanthine, creatin, etc., were the morbid agents. Perhaps the most generally accepted view now (Jaccoud), is that any or all of these substances may be present, and in part responsible. The most striking fact against the acceptance

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