AMYLOID 421 



marked cholesteroleinia as accompanying severe parenchymatous nephritis, but 

 not cluonic interstitial typos. K'ollert and FinKor'"" state that hypercholestero- 

 lemia up to ().2S per cent, may be found, but only when the kidney is excreting 

 lipoids, and believe that the cholesterol is at least partly responsible for albuminuric 

 retinitis. Bloor,^" however, found no change in the blood cholesterol in nephritis. 

 The blood content has been reported as low in febrile cutaneous di.seases, but 

 high in afebrile cutaneous diseases associated with eosinophilia.^" However, 

 DiMiis^' states, after examination of a largo nundier of cases, that hypercholestero- 

 loinia was found only in diabetes, and that low cholesterol values are found in 

 cachexia or prostration, but are not characteristic of anj' particular disease. In 

 Japan low values have been observed in beriberi, high in homiplegia.^'* Numerous 

 investigators have described hypercholesterolemia in patients with gall-stones (7. 

 V.) and attribute a causal relation thereto. The importance of the cholesterol of 

 the blood in hemolysis and protection therefrom has been discussed under that 

 subject; in anemia there is usually hypocholesterolemia. 



Experimental hypercholesterolenua in animals leads to a deposition of choles- 

 terol in various organs, especially the aorta,*' kidneys and liver, accompanied by 

 degeneration in the parenchymatous structures, and excretion of cholesterol in 

 the urine and bile; gall-stones may be formed (Dewey). Sometimes lipoid-filled 

 endothelial cells become so abundant in the spleen as to resemble Gaucher's dis- 

 ease (Anichkov, McMeans**). Excessive cholesterol in the blood reduces phago- 

 cytic activity and antibody formation in experimental animals.*^ Robertson be- 

 lieves cholesterol to have an accelerative action on cancer growth, related to its 

 hydroxyl radical, '^^ but in cancer patients there seems to be no cholesterolemia 

 (Denis). ^^^ 



The ratio of free cholesterol to cholesterol esters in normal human blood is 

 nearly constant, the esters being about 33.5 per cent, in the blood and 58 per cent. 

 in the plasma; in preganncy and during fat absorption the proportion of choles- 

 terol esters is high, in cancer and nephritis it is low.^^ The blood of the fetus 

 contains free cholesterol but no cholesterol esters. 



AMYLOID28 



Virchow, in 1853, made the first study of the nature of the substance 

 characteristic of ''lardaceous" degeneration, and considered it to be 

 a sort of animal cellulose, because it often became blue if treated with 

 iodin followed by sulphuric acid. To this resemblance in staining 

 reaction we owe the unfortunate, misleading, but generally used, name 

 amyloid."^ It was but a few years (1859) before Friedreich and 



»»" Mtinch. med. Woch., 1918 (65), 816. 



1^ Jour. Biol. Chem., 1917 (31), 575; also Kahn, Arch. Int. Med., 1920 (25), 112. 



2" Fischl, Wien. klin. Woch., 1914 (27), 982. 



" Jour. Biol. Chem., 1917 (29), 93. 



22 Bull. Naval Med. Assoc, Japan, Feb., 1919. 



" See Adler, Trans. Assoc. Amer. Phys., 1917 (32), 255. 



24 Jour. Med. Res., 1916 (33), 481. The material in the cells in Gaucher's 

 disease is perhaps a protein-phosphatid compound (Mandelbaum and Downey, 

 Fol. Hematol., 1916 (20), 139. 



2^ Dewey and Nuzum, Jour. Infect. Dis., 1914 (15), 472. 



" Jour. "Cancer Res., 1918 (3), 75. 



^^^ Luden reports an increase (Jour. Lab. Clin. Med., 1916 (1), 662. 



" Bloor and Knudson, Jour. Biol. Chem., 1917 (29), 7; 1917 (32), 337. 



-8 General literature to 1893, see Wichmann, Ziegler's Beitr., 1893 (13), 487; 

 also Lubarseh, Ergeb. allg. Path., 1897 (4), 449; discussion in the Verh. Deut. 

 Path. Gesellsch., 1904 (7), 2-51; Davidsohn, Virchow's Arch., 1908 (192), 226, 

 and Ergebnisse allg. Path., 1908 (12), 424. 



-^ In view of the fact that this substance is chemically related to chondrin, 

 and that it also closely resembles this substance physically, it has seemed to the 

 writer that the name '"'chondroid" would be much more appropriate than any of 

 the many more or less misleading and inappropriate titles that are at present in 

 use. The very multiplicity of these terms, however, prohibits any attempt to 

 introduce still another. A particularly unfortunate source of confusion exists 

 in the use of the name amyloid for a vegetable substance, formed by the action 

 of acids upon cellulose. 



