436 IMMUNO-CATALYSIS 



tissue damage. Microscopic examination of the kidneys of both rats and 

 rabbits revealed cloudy swelling and vascular congestion, degeneration 

 of the cells of the collecting and distal convoluted tubules, massive dep- 

 osition of eosinophilic granular and fibrillar material in the tubules 

 and glomerular spaces, and focal collections of lymphocytes in the 

 interstitial tissue about the degenerated distal convoluted tubules and 

 arterioles. The liver shov^^ed various degrees of damage from cloudy 

 swelling and vascular congestion to focal or massive necrosis and in- 

 filtration of the portal areas with neutrophiles and lymphocytes. The 

 urine from animals in shock frequently contained large quantities of 

 erythrocytic, hyaline, and granular casts. Certain unpublished data 

 suggested to them the release of proteolytic enzyme in extensive tissue 

 damage producing changes at the site of injury and other catabolic 

 effects. 



A report by Miller (1940) shows that protein breakdown occurs 

 during anaphylactic shock in the dog. Many other forms of injury 

 also produce similar effects. Yet, according to Miller, the results sup- 

 port the proteolytic theory of antigen-antibody combination. The 

 severity of the clinical response to an intravenous shock dose of horse 

 serum in a previously sensitized normal dog is definitely paralleled 

 by the increase in urinary nitrogen. When the clinical response is 

 severe as indicated by a profound fall in blood pressure, prolonged 

 bloody diarrhea, vomiting, and collapse, there is a very pronounced 

 increase in total urinary nitrogen with increase in the urea and am- 

 monia fractions, while the creatine shows little change. These changes 

 which have also been observed in other injuries, indicates cellular 

 injury resulting from antigen-antibody combination. 



A large increase in urinary creatine is associated with tissue injury 

 of any type, disintegration of muscular tissue, or in fever; it occurs in 

 the urine from carcinoma of the liver, in pregnancy, or after fasting, or 

 intake of a high carbohydrate diet associated with muscular activity. 

 Decreased creatine excretion has been noted in decreased carbohy- 

 drate intake. The response of smooth muscle tissue involved in the 

 early acute stage of anaphylactic reaction could very well be re- 

 sponsible for the increased urinary excretion of creatine. 



Increased elimination of uric acid in the urine is associated with 

 injury to the liver, resulting in the failure of the liver to oxidize uric 

 acid to allantoin. 



