AUTOLYSIS IN PATHOLOGICAL PROCESSES 87 



necrotic tissue by leucocytes seems also to be relatively unimportant. 

 Suppuration, therefore, must be considered as the result of digestion 

 of dead tissue by enzymes derived from the leucocytes, the plasma, 

 the bacteria, and the destroyed cells themselves. A tubercle does 

 not ordinarily suppurate, because the tubercle bacillus and the sub- 

 stances it produces are not strongly chemotactic, and hence not 

 enough leucocytes enter the necrotic area to produce a digestive 

 softening. 



The products of autolysis may of themselves be toxic; albumoses 

 and peptones certainly are, and the other cleavage products are prob- 

 ably not altogether innocuous. (See "Autointoxication.") Some of 

 the symptoms of suppuration, particularly the fever and chills, have 

 been ascribed to the autolytic products rather than to the bacterial 

 poisons, particularly as aseptic suppuration is accompanied by fever. 

 Jochmann^^ has found evidence that the protease of leucocytes can 

 cause fever and also reduce the coagulability of the blood. The work 

 of Vaughan and other recent students of the reaction to foreign pro- 

 teins, shows that typical fevers can be produced by the enzymatic 

 disintegration of proteins in the body.^'* Degenerative changes in 

 nervous tissue are associated with autolytic decomposition of the 

 lecithin (NolP^) and the liberated choline, or its more toxic derivatives, 

 may be a source of intoxication.^^ In all conditions associated with 

 autolysis, such as resolving pneumonic exudates, large abscesses, soften- 

 ing tumors, etc., albumoses (and peptones?) may appear in the urine. 

 Autolytic products may also be hemolytic (Levaditi^^), and they may 

 prevent clotting of the blood (Conradi^^). It is probable that among 

 the products of autolysis are bactericidal substances, ^^ although it is 

 doubtful if the concentration is often sufficient for them to be of 

 influence except in well walled areas. 



There is also much evidence that after extensive traumatism, 

 especially as observed in war, the products of the tissue autolysis may 

 be responsible for serious intoxication, and possibly for conditions 

 interpreted at times as shock. ^ The observations made in experimental 

 anaphylaxis suggest that it is especially the slightly altered proteins, 

 perhaps only changed in their colloidal properties, that are most likely 

 to be responsible for these shock-like intoxications. However, it is 

 also possible that amines derived from the aminoacids may be of 



9'Virchow's Arch., 1908 (194), 342. 



9^ See Vaughan, "Protein Split Products," Philadelphia, 1913. 

 « Zeit. phvsiol. Chemie, 1899 (27), 380. 

 9« See Halliburton, Ergebnisse der Physiol., 1904 (4), 24. 



" Ann. d. I'lnst. Pasteur, 1903 (17), 187; also Fukuhara, Zeit. f. exp. Path. u. 

 Pharm., 1907 (4), 658. 



98 Hofmeister's Beitr., 1901 (1), 136. 



99 See Bilancioni, Arch, farmacol., 1911 (11), 491. 



1 Delbet, Bull. Acad. Med., 1918 (80), 13; Cannon, Compt. Rend. Soc. Biol., 

 1918 (81), 850; Turck, Med. Record, June 1, 1918. 



