554 ABNORMALITIES IN METABOLISM 



but Slowtzoff^^ found both peroxidase and protease decreased, and 

 attributed the increased autolysis to a greater acidity of the Uver. 

 Burge*" describes decrease in the catalase of hver and blood in experi- 

 mental phosphorus poisoning, and Simonds^^ found hepatic ereptase 

 also decreased, but not in chloroform poisoning; esterase was not 

 altered. 



The Blood. — In the blood marked changes are found, one of the 

 most prominent, besides the icterus, being the decreased coagulability 

 of the blood. This seems due to a loss of fibrinogen,"*- which, with 

 the globulin, is greatly decreased, the albumin remaining less altered. ^^ 

 The fibrin-ferment also seems to be decreased. These changes may 

 be due to direct autolysis of the blood constituents (Jacoby having 

 found that thrombi become rapidly dissolved in phosphorus-poison- 

 ing) or to the changes in the liver. The icterus depends apparently 

 upon lesions of the finest bile capillaries,*^ although there is also some 

 increase in hemolysis, and a decrease in the total blood and all its 

 elements (Welsch);*' and both bile salts and pigments appear in the 

 urine. In all these diseases with marked liver changes there is an 

 increase in the lipase of the blood. ^"^ Neuberg and Richter'*^ have 

 analyzed the blood drawn during life from a patient with acute hepatic 

 atrophy, and isolated from 355 c.c. of blood 0.787 gm. tyrosine, 1.102 

 gm. leucine, and 0.240 gm. of lysine; they estimated the amount of 

 free amino-acids in the entire blood to be about 30 grams. *^ This 

 amount is so large that they question the possibilit}' of it all arising 

 from the degenerated liver tissue. In dogs suffering from chloroform 

 necrosis of the liver or phosphorus poisoning the amount of free amino 

 acids in the blood and urine is usually very small. "'^ 



By the use of Van Slyke's method it has been found that acute 

 yellow atrophy is accompanied by the highest amino-N figures in 

 the blood recorded in any disease, Feigl and Luce^" having reported 



39Biochem. Zeit., 1911 (31), 227. 



" Amer. Jour. Physiol., 1917 (43), 545. 



*i Jour. Exp. Med., 1918 (28), 673. 



« Whipple and Hunvitz (Jour. Exper. Med., 1911 (13), 136) find a great 

 decrease in fibrinogen during experimental choloroform necrosis of the liver. 



*^ Jacoby, loc. cit.;^^ see also Doj'on, Compt. Rend. Soc. Biol., 1905 (58), 493; 

 and 1909, Vol. 66. 



/^ Lang (Zeit. exp. Path., 1906 (3), 473) found fibrinogen in the bile of a dog 

 poisoned with phosphorus, which may account for the occlusion of the bile vessels 

 and the resulting jaundice. 



« Arch. int. Pharm. et Th6r., 1905 (14), 197. 



*« Whipple et al.. Bull. Johns Hopkins Hosp., 1913 (24), 207 and 357. Quinan 

 found the lipase content of liver tissue much reduced in chloroform necrosis 

 (Jour. Med. Res., 1915 (32), 73). A review of work published on blood changes 

 and liver function in phosphorus and chloroform poisoning is given by Marshall 

 and Rowntree, Jour. Exp. Med., 1915 (22), 333. 



" Deut. med. Woch., 1904 (30), 499. 



*' V. Bergmann (Hofmeister's Beit., 1904 (6), 40) was able to isolate 2.3 grams 

 of amino-acids combined with tlie chloride of naphthalene sulphonic acid, from 

 270 c.c. of blood in a case of acute vellow atrophv. 



" See Van Slyke, Arch. Int. Med., 1917 (19)," 77. 



»» Biochem. Zeit., 1917 (79), 162. 



