226 CHEMISTRY OF THE IMMUNITY REACTIONS 



established. Here also the hemolysis seems to take place in the endo- 

 thelial cells rather than in the vessels. In such a disease as pernicious 

 anemia there is much reason to assume that defective or abnormal 

 hematogenesis is an important factor. Probably the anemia of 

 nephritis is at least partly the result of hemolytic action of the 

 retained products of metabolism, in which connection the hemolytic 

 properties of ammonium compounds may be recalled. In some diseases 

 associated with anemia it has been found that the blood-serum of the 

 patient is cUstinctly isohemolytic, although isoagglutination seems to 

 be more frequent. The fluids that can be obtained from cancers have 

 been found to be hemolytic, while antihemolysin has been found in 

 ascitic and pleural effusions. Autolytic disintegration of hver, and 

 presumably other tissues, may also cause the presence of hemolytic 

 substances in the blood. ^^ Arseniuretted hydrogen may produce 

 hemolysis in some such way, since it causes no hemolj^sis in the test 

 tube (Heffter). The very great hemolytic action of soaps and free 

 fatty acids, which varies directly with the number of unsaturated 

 carbon atoms they contain (Moore^^), makes it possible that these 

 substances play a part in the hemolysis of disease, especially since the 

 fatty acids of the liver are characterized by their high content of free 

 fatty acids. Bile is strongly hemolytic, and in icterus this is an im- 

 portant consideration. 



In many forms of poisoning hemolysis is a prominent feature; in 

 some it seems to be the chief effect of the poison, e. g., potassium 

 chlorate and arseniuretted hydrogen. In severe extensive burns there 

 may occur hemolysis, and hemoglobinuria may also result. The hemo- 

 globinuria of "blackwater fever" has been the cause of much discus- 

 sion as to whether the malarial parasite or the quinine is the cause, 

 with a divided opinion resulting, although, undoubtedly, cases do occur 

 in malaria without administration of quinine. The studies of Brem-® 

 indicate that the hemolysis is produced by a hemolysin coming from 

 the Plasmodium, and that the quinine influences the condition by 

 preventing the action of an antihemolytic substance present in the 

 blood. 



After removal of the spleen, hemolysis by the hemolymph glands 

 exceeds that of the primitive spleen, causing an excessive destruction 

 of red corpuscles (Warthin^"). This suggests that the spleen may 

 normally dispose of some hemolytic agent which acts either by stimu- 



" Maidoni, Biochoin. Zeit. ,1912 (45), 328. lieinolytic lipoids are believed by 

 some to l)e liheruted from injured tissues (see Kirsche, Hiochem. Zeit., 1913 (55), 

 169), but McPhedran (Jour. Exp. Med., 1913 (18), 527) could find no evidence 

 that any particularly hemolytic fatty ucid, more active than oleic acid, can be 

 isolated from either normal or diseased tissues. 



"^^ Brit. Med. Jour., 1909 (ii), 684; sec al.so Lamar, Jour. Exper. Med., 1911 

 (13), 380. 



2» Arch. Int. Med., 1912 (9), 129. 



a" Jour. Med. Research, 1902 (7), 435. 



