SIGNIFICANCE OF AUTOINTOXICATION 593 



possible, however, that a serious reduction in the bases of the blood may result from 

 the formation of excessive amounts of fatty acids in the intestines, the bases being 

 coml)ined to unite with the fatty acids, and then excreted in the feces. 



It is quite otherwise with the jiroducts of decomposition of lecithin.*^ From 

 its molecule is split off the ptomain, choline, 



(CHa)., s N - CH, - CHjOII 



Ah 



which is easily oxidized into a highly poisonous compound, isomeric with mus- 

 carine, or by losing a molecule of water it forms neuritiie, 



(CH3), = N— CH = CHi 



I 



OH 



which is also very poisonous (discussed under "Ptomains," Chap. iv.). It has 

 been demonstrated by Nesbitt^' that in the contents of obstructed intestines of 

 dogs that have been fed Iccithin-ricli food (eggs) both clioline and neurine may be 

 found free, and Kutscher and Lolimann' have found neurine in human urine. It 

 seems possible that some of the toxic effects observed after eating excessively of such 

 food as calves' brains, or eggs, may depend upon intoxication witli the products of 

 lecithin decomposition. Also, the normal presence of trimethylanrx.ine in the blood 

 and cerebrospinal fluid (Dorce and Golla)- may be from this source. Hunt,' who 

 has done extensive work with choline, states that at present, we have no grounds for 

 believing that choline has any significance in physiological or pathological pro- 

 cesses. There is no evidence that the highly active acetyl-cliolinc'' is produced 

 from choline in the bodj^, but in view of the enormous toxicity of this choline de- 

 rivative there must always be considered the possibility that such toxic choline 

 compounds may at times develop in amounts too small to be detected but large 

 enough to cause effects. 



Results Of Gastro-Intestional Intoxication 



As we have seen from the above, but few of the known products of 

 gastro-intestinal putrefaction are toxic to any considerable degree, 

 and these are probably produced in too small quantities to cause any 

 appreciable effect, especially in view of the detoxicating and eli mi- 

 natory powers of the liver, kidney, and other organs. And yet we 

 have abundant clinical evidence that excessive intestinal putrefaction 

 or retention of the intestinal contents causes marked disturbance in 

 health. The slight malaise, headache, and lassitude observed as the 

 result of simple constipation may possibl}^ be adequately accounted for 

 by intoxication with indole and similar substances, although we have 

 no conclusive proof that such is the case. Two explanations may be 

 suggested : One is that the intestinal flora becomes altered because of 

 the changed conditions, and bacteria thrive that produce specific 

 soluble toxic substances, analogous to those formed by B. hotuUtius, 

 or similar to the hjrotoxicon (Vaughan) that may be formed in milk 

 and milk products. Thus Clairmont and Ranzi^ found heat-resistant 



^* Literature given by Halliburton, Ergebnisse der Phvsiol., 190-4 (4\ 24. 

 "Jour. Exp. Med.,' 1899 (4), 1; see also Hoesslin, "Hofmeister's Bcitr., 1906 

 (8), 27. 



' Zeit. phvsiol. Chem., 1906 (48), 1. 



- Biochem. Jour., 1910 (5), 306. 



3 Jour. Pharmacol., 1915 (7), 301. 



^ See Dale, Jour. Pharmacol., 1914 (6), 147. 



6 Arch. klin. Chir., 1904 (73), 696. 



38 



