POrSOXS OF BURNS 573 



than tho nccrop;onic suhstanco, whicli is very easily destroj'od by heat. 

 Pfciffcr behoves it probable that the poisons arc derived from the 

 cleavage of proteins altered in composition by burning, and he finds 

 an enzyme splitting glyc3'ltryptoj)hanc in the blood and urine of 

 burned animals.-'^ The hemolysis ho attributes to direct injury of 

 the blood in its passage through the heated area, and not to the action 

 of poisons; this is very possible, since red corpuscles fragment after 

 being heated to 52°, and may be seriously impaired functionally at 

 45°. There are many authors, indeed, who consider the blood changes 

 the chief cause of death, but the weight of evidence is in favor of tho 

 theory of the development of toxic substances in the burned skin. 



Kutscher and Heyde^- believe methyl guanidine to be the toxic 

 substance eliminated in the urine, stating that it produces effects sim- 

 ilar to that caused by injections of tho toxic urine from burn cases. 

 These symptoms are quite similar to those characteristic of anaphy- 

 laxis, and Heyde states that small burned areas sensitize an animal 

 to later injections of extracts of burned tissue. He, as well as Vogt, 

 are therefore inclined to believe that some cases, especially those dy- 

 ing unexpectedly 12 or 13 days after the burning, may be the result 

 of anaphylactic reaction to proteins made of foreign character by the 

 heat.^^ The newer observations concerning the presence of toxic sub- 

 stances in the urine during anaphylactic intoxication are in harmony 

 with the findings in burn cases, ^■^ although the identity of method 

 guanidine with the toxic agent is questionable. 



Burn Blisters. — -The contents of burn blisters resemble the fluid of 

 inflammatory edemas generally. K. Mornor^^ found 5.031 per cent, 

 of proteins, which included 1.359 per cent, of globulin and 0.011 

 per cent, of fibrin; there was also present a substance reducing cop- 

 per oxide, but no pyrocatechin. 



31 Zeit. Immunitiit., 1915 (23), 473. 



32 Cent. f. Phvsiol., 1911 (25), 441. 



" Heyde, Med. Klinik, 1912 (S), 263. 



3^ See Pfeiffer, Zeit. Immunitat., 1913 (18), 75. 



35 Skand. Arch. Physiol., 1S95 (5), 272. 



