574 XII. HEMOGLOBIN CATABOLISM, II 



atrophy of the liver and other cases of severe Hver damage (232,639,735), 

 eclampsia {2^88,2490,2000,2507), after drugs and poisons such as acetanilide, 

 pamaquin {592), phenylhydrazine, aromatic nitro compounds {2488,2^90, 

 2500,2507), and occasionally also porphyria and lead poisoning (638,735, 

 2491,2507). With the possible exception of the last-named conditions, one 

 can say that "hematinemia" occurs under conditions of rapid hemolysis or 

 severe liver damage, generally only in traces, but more strongly if the two 

 factors are combined (cf. 232). In such cases Schumm speaks of "hematin 

 icterus," although pure hematin icterus is probably restricted to severe 

 sepsis. 



Physiologically hematinemia has been found in the second half 

 of the fetal period and in the blood of the umbilical cord (638,1150); 

 it has also been claimed that hematin is present in the plasma of 

 normal bird blood (268,271). 



After intravenous hemoglobin injection "hematinemia" has been 

 observed by Fairley (733), while according to Duesberg (639) hematin 

 is only formed from injected hemoglobin if the liver is damaged. 

 This probably also holds for the hematinemia of pernicious anemia. 

 Vaughan (2861) did not find hematinemia in increased blood destruc- 

 tion following the injection of long-stored blood. 



According to Fairley (cf. Chapter VI, Section 3.3.5.), hematin is 

 not present in the blood as such, but in combination with serum 

 albumin as methemalbumin (ferrihemalbumin), although the absorp- 

 tion band of methemalbumin in the orange part of the spectrum 

 could not be observed in all instances in which the Schumm test was 

 positive. 



If hemoglobin sufficient to cause a concentration of 200-230 mg. 

 per 100 ml. in the plasma is injected intravenously, methemalbumin 

 is found after four to ten hours and persists for 27-34 hours (733). 



2.2. Hematin. in Blood Extravasations and in 

 the Malarial Red Cell 



Hematin has been found in large blood extravasations, particularly 

 in ruptures of ectopic pregnancies (266, 2^52, 21,90; 2989, p. 2462). If 

 hematin is present, hemorrhagic transudates contain less bilirubin 

 than usual. 



The brown pigment in the erythrocytes in malaria is free hematin 

 (89,352,353,402,1988,2299,2569,3014) or hematin combined with a 

 protein different from serum albumin (997; 1213, p. 117). It can be 

 extracted with 0.5% sodium carbonate solution, which does not alter 

 hemoglobin (1988). Only after having been set free by the disinte- 



