96 ENZYMES " 



It is probable that many poisons may injure the liver cells to such 

 an extent that they cannot maintain their normal chemical equili- 

 brium, but without destroying the autolytic enzymes. When this 

 occurs, the liver undergoes autolysis, and we get marked degenerative 

 changes with appearance of amino-acids in the blood and urine, 

 reduction in coagulability of the blood and numerous hemorrhages, 

 giving a picture both clinically and anatomically more or less like that 

 of typical acute yellow atrophy. Chloroform is a poison that stops 

 cell activities without destroying the proteolytic enzymes, hence 

 the cells undergo autolysis, and, as a result, we have many cases of 

 what appears to be acute yellow atrophy following chloroform anes- 

 thesia. The liberation of HCl in the liver cells during chloroform 

 poisoning, as demonstrated by Evarts Graham, ^'^ may be largely re- 

 sponsible for the rapid disintegration of the liver in this condition. ^^ 

 (See ''Acute Yellow Atrophy, " Chap, xx.) Probably the liver changes 

 in puerperal eclampsia, and in streptococcus and other septicemias are 

 of a similar nature. ^^ Autolysis of fatty livers in tuberculosis is said 

 to yield more lactic acid than the livers from other conditions (Yous- 

 souf).60 



Postmortem changes are undoubtedly due to two factors, bac- 

 terial action and autolysis. In tissues kept at a low enough tempera- 

 ture to exclude bacterial action, but not so low as absolutely to stop 

 enzyme action, ^^ there occurs a slow autolysis; this constitutes the 

 "ripening" process of meat. Fish flesh may also ripen when made 

 sterile in saturated salt solutions, as Schmidt-Nielsen^"^ has shown 

 occurs with salted herrings, oxy-acids and xanthine bases being promi- 

 nent among the products. The softening of muscles in rigor mortis is 

 probably also an autolytic manifestation, as muscles contain proteases 

 acting best in acid medium, and the muscle is known to become in- 

 creasingly acid after circulation ceases within it. The short duration 

 of rigor mortis when the body is kept warm, and its early disappear- 

 ance when death has been preceded by muscular exhaustion (which 

 increases the acidity), agree with this view. The oarly postmortem 

 softening of many organs in pathological conditions is also probably 

 an autolytic manifestation. Flexner-'^ has called attention to this 

 in relation to the softening of the parenchymatous organs in acute 

 infectious diseases, such as typhoid and septicemia. Scluunm noted 

 great autolytic activity in a swollen spleen from a case of perityphlitis. 



" Jour. Exp. Med., 1915 (22), 48. 



68 Quinan (.Tour. Med. Res. 1915 (.32), 73) found no ehanfre in the rate of 

 in tritro autolysis of liver tissue from experimental cliloroform poisoning. It was 

 found increased by phlorhizin (Satta and Fasiani, Arch. di. Fisiol., 1913 (11), 

 391). 



f-a Wells, Jour. Amer. Med. Assoc, 190G (40), 341. 



6" Virchow's Arch., 1912 (207), 374. 



*' Some chemical chaufre may taivc i)lac.e at temiieratures as low as —2 and — 14 

 (Costantino, Arch. farm, sper., 1917 (24), 255). 



«Mrofmeister's Heitra^rc, l«K)3 (3). 2(57. 



