is of the highest importance for the nutriment of the body. Under ordinary circumstances, nearly the whole of the sugar formed in the intestine and absorbed from it is arrested in the liver, so that very little passes into the general circulation and appears in the urine, although even in healthy persons traces of sugar are excreted by the kidneys. Under exceptional circumstances, however, sugar may pass through in considerable quantities, as, for example, when the individual takes, on an empty stomach, a large quantity of sirup. However healthy his organs may be, sugar will then appear in the urine. The same is the case in regard to albumen. Usually, the whole albuminous constituents of our food are so transformed in the stomach, intestines, and liver, that no albuminous substances of the kind which can pass through the kidneys get into the general circulation. But, if one takes such a quantity of eggs as to completely overtask the digestive powers, the egg-albumen will pass unchanged into the blood, and be excreted by the kidneys.
Other albuminous substances, the products of intestinal digestion, and peptones also, occasionally make their appearance in the urine, as well as egg-albumen. Even when the processes of assimilation are not so seriously interfered with as in these instances, we observe that products of nitrogenous waste frequently occur in the form of lithates in the urine. An excess of these indicates some pathological condition, even although it may be very trivial. We can not, indeed, say what the exact condition is, because we find lithates appearing in the urine after violent muscular exertion accompanied by profuse sweating, so that they may possibly represent some of the products of muscular waste; but we also find that they occur in large quantities in the urine after slight indiscretions in diet, although no muscular exertion has been undergone, and in these cases we can hardly do otherwise than regard them as products of the imperfect assimilation of nitrogenous matters which ought to have been eliminated, not in the form of urates, but of urea. Now, physiological experiments and observations indicate that the liver is the chief if not the only part of the body in which urea is formed. This at least appears to be the case excepting in febrile conditions, in which, possibly, the urea may also be formed, to a considerable extent, in the muscles. The old notion, then, which connected the appearance of lithates in the urine with disordered function of the liver, is probably in a great measure correct. There is little or no reason to believe that these lithates are formed in the kidneys. They are, probably, simply separated by them from the blood, and their presence in the urine would therefore indicate their presence in the blood and tissues. Now, lithates in themselves do not appear to have any particularly injurious effects, either upon the nervous tissues or the muscles, but, as their presence indicates deficient assimilation, they may be accompanied by other substances which have a much more pernicious action, just as there are
