HEMOLYSIS 215 



tliat the toxic serum has brought about changes. Much of our knowl- 

 edge of bactericidal serum has been obtained through studies of the 

 mechanism of erythrocytolysis, tlie results of which have then been 

 applied to the subject of bacteriolysis. Both on this account, there- 

 fore, and because solution of red corpuscles is of itself an important 

 process in manj- intoxications and diseases, the subject is of great 

 theoretical and practical importance. 



HEMOLYSIS 1' OR ERYTHROCYTOLYSIS 



In hemolysis the essential phenouienon consists in tlie escape of 

 the hemoglobin from the stroma of the corpuscles into the surround- 

 ing fluid. As it is not exactly known in what way the stroma holds 

 the liemoglobin normally, whether purely physically or in part chem- 

 ically, or whether the stroma consists of a spongioplasm or sac-like 

 membranes, or both, the ultimate processes that permit the escape of 

 the liemoglobin are not finally solved. However, the agents by which 

 the escape is brought about are well known and extensively studied, 

 and they are found to be of extremely various natures. They may 

 be roughly classified as: (1) known physical and chemical agents; (2) 

 unkno^^Ti constituents of blood-serum; (3) bacterial products; (4) 

 certain vegetable poisons ; (5) snake venoms. 



HEMOLYSIS BY KNOWN CHEMICAL AND PHYSICAL AGENCIES 



The Mechanism of Hemolysis. — If distilled water is added to 

 corpuscles of any kind, osmotic changes are bound to occur, since 

 within the cells are abundant salts, soluble in water, which will begin 

 to diffuse outward in an attempt to establish osmotic equilibrium be- 

 tween the corpuscles and the surrounding fluid., Converselj^, water 

 enters the corpuscles at the same time, and accumulating there leads 

 to swelling until such injurv^ has been produced as permits the hemo- 

 globin to escape and enter the surrounding fluid. Before this oc- 

 curs the fluid is opaque because of the obstruction to light offered 

 by the red cells, but on the completion of hemolysis the fluid becomes 

 transparent. The stroma now settles to the bottom, while the hemo- 

 globin diffuses into the fluid, making- it red, but perfectly transparent. 

 This process has long been known as the "laking" of blood, and is 

 essentially the condition present in all forms of hemolysis. That the 

 hemoglobin escapes only through injure* of the stroma and not 

 through simple osmotic diffusion, is shown l)y the fact that if salt 

 .solution of the same concentration as normal serum is used instead 

 of distilled water, no such escape of hemoglobin occurs. As hemo- 

 globin is perfectly soluble in salt solution, it should pass out if it dif- 



17 Through usage this term has been limited to the solution of the red cor- 

 puscles, which is more accurately described by the term erf/throriitolf/is. For 

 bibliography see Sachs, Ererebniss'e der Pathol.,' 1002 (7), 714: 1900 (11), 515; 

 Kolle and Wassermann's Handbuch. 191.3 (II), 793; Landsteiner, Handbuch d. 

 Biochem., 1909 (II (1)), 395. 



