ARTICLES 427 



found that in shock due to loss of blood the tissue fluids which 

 replaced the plasma were poor in catalase, and oxidation 

 processes were consequently much reduced. They concluded 

 from this that the beneficial effect of alcohol in such cases was 

 due to stimulation of the liver catalase. 



These facts and reference to the stimulation of the splanch- 

 nic nerves — ^which shows that the excretion of catalase is 

 under the control of the sympathetic nervous system — suggest 

 that a catalase deficiency may play a considerable part in the 

 fall of temperature which takes place in cases of surgical shock. 

 Indeed the recent war has shown that the fall of temperature is 

 just as important as the fall of blood-pressure — upon which so 

 much stress has been laid by Crile and Mummery. In this 

 connection it may be mentioned that although the keeping 

 warm of patients suffering from shock has for many years been 

 considered a point of importance in the treatment of such 

 cases, experience in war has caused great emphasis to be laid 

 on it by modern surgeons, and this factor was very seriously 

 considered in the arrangements for the evacuation of wounded. 

 As the heat of the body varies with oxidation processes, which 

 from the work reviewed above appear to depend to a great 

 extent on catalase, it is possible that the production of shock 

 in cases of severe injury may partially at least be dependent 

 on an inhibition of catalase secretion through the sympathetic 

 nervous system. Unfortunately there is no record of the cata- 

 lase content of the blood having been determined in such a case 

 of shock, but the decrease in catalase in shock due to loss of 

 blood would tend to support this hypothesis. 



Kennedy and Burge (191 7) found that the livers of pan- 

 creatised dogs were deficient in catalase, and suggested that the 

 lack of oxidation in diabetes might be due to such a catalase 

 deficiency. The discussion of an enzyme theory of causation 

 of diabetes is too long to be entered into here. 



Although the careful work of Burge is very attractive, it is 

 nevertheless necessary to add that his results regarding increase 

 of catalase due to rejection of meats and protein food products 

 have not been confirmed by Stehl (19 19), who considered the 

 fluctuations to be due to the red blood corpuscles. Bodansky 

 has also attempted to check some of Burge's results, and comes 

 to the conclusion that no satisfactory method for the estimation 

 of catalase exists. Very slight changes in temperature, im- 

 purities, and especially the reaction of the hydrogen peroxide 

 affect the result. He found that even with the preparation 

 used by Burge, results may differ as much as from 1 5 per cent, 

 to 30 per cent. 



Burge (19 1 8) showed that catalase is destroyed by anses- 

 thetics, and suggests that anesthesia may be so produced. Its 



