NECROSIS 377 



Hertwigs show that the chromatin is chiefly affected, which presum- 

 ably explains the fact that immature cells, and cells in active division, 

 are more sensitive to a:-rays than adult cells, and that monstrosities 

 develop from eggs exposed to radiant energy. As far as histological 

 changes show, hard rays produce less but (juite the same changes as 

 soft rays. That .r-rays have a marked effect on metabolism has been 

 abundantly established.^'' According to Musser and Edsall,®" the ef- 

 fect of :r-rays upon metabolism is unequalled by any other therapeu- 

 tic agent, and is manifested by excessive elimination of the products 

 of protein destruction, which arise particular!}' from the lymphatic 

 structures. '^' These changes have been studied, therefore, particu- 

 larly in connection with the treatment of leukemia {g. v.). In con- 

 sequence of the injury to the blood-forming tissues, resistance to bac- 

 teria is decreased (La wen). ^^ The renal epithehum seems also to 

 suffer injury in some cases. ""^ 



Exposure of the entire body of animals, or large areas of hemato- 

 poietic tissue in man, leads to profound changes. Chief of these are 

 destruction of lymphoid cells, pigmentation of the spleen, destruction 

 of bone marrow cells, primary rise in poh^morphonuclear cells followed 

 by a fall to below normal, stead}' decline in lymphocyte count, and 

 an increased resistance of the red cells to radiation. "^^ So marked may 

 be the effect of x-rays on the marrow and spleen that antibody forma- 

 tion is greatly depressed (Hektoen).^^ After heavy doses marked 

 metaboHc changes occur which indicate a profound intoxication, there 

 being vomiting and diarrhoea, high non-protein N in the blood and a 

 great increase in the urinary N (Hall and Whipple).®^ These authors 

 also observed necrosis in the intestinal epi '"helium. Presumably these 

 reactions are similar to those observed following superficial burns, and 

 depend on disintegration of tissue proteins with production of toxic 

 substances. 



The long-continued action of a:-rays upon the skin has, in many 

 cases, led to the formation of cancer, apparently because the pro- 

 liferation stimulated by the rays progresses until it exceeds normal 



^^ See Harvey (Jour. Path, and Bact., 1908 (12), 548), concerning the effects of 

 x-rays. 



«o Univ. Penn. Med. Bull., 1905 (18), 174; also Edsall and Pemberton, Amer. 

 Jour. Med. Sci., 1907 (133), 426. 



^' A peculiar selective action for the generative cells is also shown by x-rays, 

 which cause marked atrophy of the ovaries and testicles. In the latter it affects 

 chieflv the germinative cells, sparing the cells of Leydig. (See --Ubere-Schonberg, 

 Munch, med. Woch., 1903 (50), 1850; Frieben, ibid., 1903 (50), 2295; Specht, 

 Arch. f. Gvn., 1906 (78), 458; Thaler, Deut. Zeit. f. Chir., 1905 (79), 576; Reif- 

 ferscheid, Zeit. f. Gyn., 1910 (34), 593. 



62 Mitt. Grenz. Med. u. Chir., 1908 (19), 141. 



" See Schulz and Hoffman, Deut. Zeit. f. Chir., 1905 (79), 350; Warthin, Amer. 

 Jour. Med. Sci., 1907 (133), 736. 



6^ Resume by Gudzent, Strahlentherapie, 1913 (2), 467. See also Taylor et al, 

 Jour. Exp. Med., 1919 (29), 53. 



" Jour. Infect. Dis., 1918 (22), 28. 



« Amer. Jour. Med. Sci., 1919 (157;, 453. 



