HYALINE DEGENERATION 427 



the genesis of amyloidosis. The presence of glyeothionic acid in pus'* 

 is of similar significance. The hypothesis that amyloid is formed from 

 disintegrating red corpuscles is probal)!}^ incorrect. Amyloidosis is 

 produced by the most varied species of bacteria and by their toxins, 

 although the staphylococcus is usually most effective in experimental 

 work.^^ Neither is suppuration absolutely essential, for injection of 

 toxins alone (c. g., in preparing diplit heria antitoxin'^*"'), without suppura- 

 tion, may produce amyloidosis, as also frequently does syphilis without 

 suppuration and, less often, many other non-suppurative conditions 

 (e. g., tumors). Wago^^ reports finding a widespread "amyloid-like" 

 degeneration in rabbits immunized with sterile pancreatic extracts. 



Local amyloid accumulations are of some interest in considering the genesis of 



the usual generalized form. They occur particularly as small tumors in the larynx, 

 bronchi, nasal septum, and eyelids; as all these tissues are normally rich in chon- 

 droitin-sulphuric acid, it seems probable that the amjdoid arises from a local 

 overproduction of chondroitin-sulphuric acid, which becomes bound with proteins 

 in si(u. This makes it seem more probable that, in spite of the lack of positive 

 experimental evidence, general amyloidosis is due to liberation of excessive quanti- 

 ties of chondroitin-sulphuric acid in the sites of tissue destruction. 



Another form of local amyloid is seen particularly in the regional lymph-glands 

 of suppurating areas; e. g., the lumbar glands in vertebral caries, the axillary glands 

 in shoulder-joint suppuration. This local amyloidosis is undoubtedly due simply 

 to the fact that these glands receive first, and in largest amounts, the cau.se, what- 

 ever it may be, of the amyloid production.*^ Less readily explained are cases of 

 extensive amyloidosis limited to the heart.*' 



Corpora amylacea will be found discussed under "Concretions" (Chap. xvii). 



HYALINE DEGENERATION*" 



Much confusion concerning this condition may be avoided if we ap- 

 preciate that the term hyaline indicates a certain physical condition, 

 which may be exhibited by many substances of widely different na- 

 ture and origin. There is 7io one chemical compound, ^'hyalin," 

 which, accumulating in cells or tissues, produces a hyaline appear- 

 ance. The limits of the application of the term "hyaline degenera- 

 tion," even to histological findings, is not agreed upon, but in general 

 it is used to apply to clear, homogeneous, pathological substances 

 that possess a decided affinity for acid stains, such as eosin. Some- 

 what similar substances, usually of epithelial origin, which do not 



" Mandel and Levene, Biochem. Zeit., 1907 (4), 78. 



** In a series of experiments directed to ascertain, if possible, which constituent 

 of pus might be the cause of amyloid formation, 1 was unable to secure amyloid 

 by protracted intoxication of rabbits by Witte's "peptone," which consists chiefly 

 of proteoses (Trans. Chicago Path. Soc, 1903 (5), 240). 



** See Lewis, Jour. Med. Research, 1906 (15), -449. 



"Arch. Int. Med., 1919 (23), 251. 



*^ Quite unexplained is the cause of the rarely observed localization of amyloid 

 in the wall of the urinary bladder. See Lucksch (Verb. Deut. path. Gesell., 1904 

 (7), 34). ConcretioiLs giving the amvloid reactions have been found in the pelvis 

 of the kidney. (Schmidt, Cent. f. Pathol., 1912 (23), 865. Mivauchi, ibid., 1915 

 (26), 289.) 



*9 See Hecht. Virchow's Arch., 1910 (202), 168. 



*" General literature, seeLubarsch, Ergeb. allg. Path., 1897 (4), 449. 



