Pathological Iron Metabolism 93 



In acute and febrile toxic and infectious conditions (staphy- 

 lococcal and coli-bacillary septicaemias) we noted a marked 

 fall in the circulating iron, but an enormous increase in iron 

 in the bone marrow, and some increase of iron in skeletal 

 and heart muscle and also in the nervous system. 



These results corroborate the clinical finding of a fall in 

 serum iron in acute infectious conditions, incorrectly regarded 

 as a lack of iron. The organism has, we think, lost the pro- 

 perty of transporting iron into the circulation, and this fact, 

 according to Neukomm, is to be related to fundamental 

 changes in proteins. Modifications of the iso-electric point 

 of proteins during the inflammatory process prevent the 

 fixation and transportation of iron in blood serum. In 

 addition, the increased metabolic needs of tissues (particularly 

 of muscles) lead to the retention of iron. Lastly, we find in 

 inflammatory conditions intense erythropoietic activity, due 

 to leucocytosis and hgemolysis. 



All these facts demonstrate that the metabolism of iron is con- 

 trolled primarily by the functional needs of the bone marrow. A 

 small quantity of iron may be utilized by tissues when cellular 

 regeneration, and more especially when the energy and meta- 

 bolic needs of cells, are augmented by disorders of cellular res- 

 piration (hypoxaemia, hyperthyroidism, febrile conditions, etc.). 



In connection with this last point, it is interesting to note 

 that though synthesis of haemoglobin, as shown by the 

 appearance of radioactive haemoglobin, is completed very 

 rapidly (1-2 days), that of Cytochrome C, according to our 

 own experiments, is obtained much more slowly (2-3 weeks), 

 but this time can be reduced if the animal is previously 

 treated with thyroxine. 



In the formation of haemin the thyroid gland seems to be 

 particularly active, not only by stimulating erythropoiesis but 

 also by activating the synthesis of cellular haems such as 

 Cytochrome C. 



REFERENCES 



Hahn, p. F., Bale, W. F., Ross, J. F., Hettig, R. A., and Whipple, 

 G. H. (1940). Science, 92, 131. 



