360 THE LESIONS INDUCED BY POISONS. 



with the internal secretions to furnish the necessary link in the chain of 

 intermediary metabolic products. In this group may be placed cachexia 

 struinipriva and myxcedema, pancreatic diabetes, Addisou's disease, and 

 possibly some forms of acute yellow atrophy of the liver. 



While the nature and action of the postulated internal secretions is 

 still obscure, there is much reason to believe that they do indeed exist 

 and are of extreme importance in the subtle adjustments of individual 

 cell metabolism to the welfare of the organism as a whole, and that 

 when this adjustment is disturbed, forms of histogenic auto-intoxication 

 may arise. At any rate the hypotheses which have been formed in the 

 new light have contributed largely to our understanding of a series of 

 important general diseases. These diseases, whether involving or not 

 internal secretions in accordance with our present conceptions, may be 

 considered as dyscrasic auto- intoxications. 1 



Whether gout, oxaluria, and some- forms of simple diabetes should 

 be considered as auto-intoxications may be questioned. Probably Base- 

 dow's disease and some forms of puerperal eclampsia should be regarded 

 as involving the formation and retention of histogenic poisons. 



Of course this grouping of diverse forms of disease should be consid- 

 ered as only tentative and suggestive. And it may well be doubted 

 whether analogy may not be often overstrained in regarding as the 

 effect of poisons what may after all be metabolic aberrancies of far more 

 subtle character than the word auto-intoxication would imply. 



It should be borne in mind that in but a very small proportion of 

 the abnormal processes which are considered auto-intoxications have the 

 assumed poisons been actually demonstrated. The assumption rests 

 largely upon symptoms which are regarded as analogous with those in- 

 cited by known exogenous poisons. It is wise to remember also that 

 even in poisoning by well-defined agents whose general effects have long 

 been known we are almost totally ignorant, except in the case of the so- 

 called destructive or corrosive poisons, of the exact ways in which they 

 act. A few induce changes in the blood ; many appear to act upon the 

 nerve cells ; but the nature of this action is still unknown. 2 



Without insisting upon the advantage of such a grouping as has been 

 outlined above, and with the full recognition of its incompleteness, the 

 more important of the so-called "general diseases," some of which may 

 be regarded as auto-intoxications, will be considered in the next chapter. 



1 For a discussion of internal secretions, with bibliography, consult Transactions of 

 the Congress of American Physicians and Surgeons, vol. iv., 1897. 



2 For convenience of reference the grouping of poisons briefly set forth above may 

 be tabulated as follows : 



I. Exogenous poisons Inorganic and organic. 



Endogenous poisons A ' In 



II. Endogenous poisons con- formed largely by ^ B W ithout infec t i o n 

 cerned in autochthonous or I micro-organisms. ^ e ly enterogenic' 



pnrlntrpnin nrnsnmno- auto- I T-. ^ 111 6 C V wwgwMw. 



1 Endogenous poisons formed under the influence of 

 or by the body cells histogenic poisom induc- 

 ing auto-intoxication in the more limited sense. 



