FACTORS ALTERING CONCENTRATION OF BLOOD LIPIDS 433 



a defective mechanism for the removal of blood fat by the liver, a mecha- 

 nism in which a humoral factor may be involved. 475 



b. The Blood Lipids Following Tissue Injury. Man and co-workers 477 

 observed that, after surgery, small but unequivocal decrements occurred 

 in serum lipid fractions, total and free cholesterol, lipid phosphorus, and 

 fatty acids. The lipid components were found to be proportionally 

 affected, without distortion such as occurs in liver disease. 



c. The Blood Lipids Following the Administration of Various Anes- 

 thetics. The several anesthetics have widely varying effects on the blood 

 lipids. Some of them, such as ether and chloroform, 422 produce a marked 

 hyperlipemia, while others are apparently without effect on the blood 

 lipid pattern. 



One of the early conceptions of the mechanism of ether anesthesia as 

 described by Reicher 478 was to the effect that the ether dissolved a portion 

 of the fatty material in the brain, and that the fat was transported by the 

 blood to the liver. This theory would offer an explanation for the hyper- 

 lipemia observed during anesthesia. However, since increased blood lipids 

 are not an invariable concomitant of anesthesia, one is led to question the 

 above hypothesis as an explanation of the cause of anesthesia. In fact, 

 this assumption was abandoned after the Meyer-Overton theory of narco- 

 sis was proposed and had been generally accepted. 



The increase of blood lipids is quite marked when ether or chloroform 

 is administered. Reicher 478 was able to demonstrate that blood lipids 

 were increased as much as 300% by various narcotics, and that the increase 

 affected equally the neutral fat, cholesterol, and phospholipid fractions. 

 Bloor 222 and Hospers 479 confirmed the hyperlipemia which resulted from 

 ether anesthesia, and also noted that all lipid constituents were involved 

 in this augmentation. It was later reported by Mahler 480 that this hyper- 

 lipemia could be abolished by insulin ; this is in line with the recognized im- 

 pairment in carbohydrate metabolism which is produced by ether anes- 

 thesia. The formation of ketone bodies as a delayed result of ether 

 anesthesia 481,482 is likewise in accordance with this physiological behavior. 



On the other hand, there is little evidence that chloroform anesthesia 

 elevates the blood lipids. Lattes 221 was unable to confirm the positive 



477 E. B. Man, P. G. Bettcher, C. M. Cameron, and J. P. Peters, J. Clin. Invest, 25, 

 701-708(1946). 



«™ K. Reicher, Z. klin. Med., 65, 235-268 (1908). 

 479 C. A. Hospers, Arch. Surg., 26, 909-922 (1933). 

 48 ° A. Mahler, J. Biol. Chem., 69, 653-659 (1926). 



481 J. J. Short, /. Biol. Chem., 41, 503-513 (1920). 



482 W. Thalhimer, J. Am. Med. Assoc, 81, 383-385 (1923). 



