CAUSES OF NECROSIS 379 



solutions were plaeed on the web of a frog's foot, under the micro- 

 scope; as soon as tiie solution penetrated to a capillary, stasis with 

 fusion of the corpuscles occurred in a very few seconds. Similar 

 results have been obtained by Rosenberger.'*'* Some poisons seem to 

 cause necrosis without destroyiiiu' the autolytic enzymes, in wliicli 

 ease the cells are rapidly digested ; at least, such a hypothesis seems 

 to explain best the changes seen in the liver in chloroform poisoning, 

 acute yellow atrophy, eclampsia, etc^** Not all poisons, by any 

 means, cause cell death — tetanus toxin, morphine, and other alkaloids 

 cause death of the individual as a whole without usually causing pri- 

 mary necrosis of any of the cells. Cell death does not necessarily de- 

 pend upon destruction of all the cellular enzymes, as has been pointed 

 out previously. Thus, bacteria may be killed by many chemicals 

 which seem not to att'ect their autolytic enzymes seriously. Any con- 

 siderable excess of either H or OH ions is incompatible with cell life, 

 and it is possible that at times the production of acids within a 

 cell may be sufficient to cause death °°^ (e. g., in the kidney in acute 

 nephritis (]\I. H. Fischer), or in the muscle in waxy degeneration 

 (Wells) ■'"''■"'. It is quite probable that many of the poisons act by 

 interfering with the oxidative capacity of the cells; this seems almost 

 certain in the case of chloroform necrosis, and even bacterial poisons 

 (diphtheria and typhoid) were found by Pitini *'° to decrease the 

 oxidizing power of the cells. 



The term, "protoplasmic poison," has been variously used and de- 

 fined. Kunkel says that a protoplasmic poison "is a poison which, 

 without producing directly evident alterations, harms or kills all 

 living protoplasmic structures." HgCU is such a poison, whereas 

 HoSOj, bromine, and similar substances that destroy all life through 

 their strong chemical action are not included in this category. The 

 protoplasmic poisons presumably act by combining with one or more 

 of the constituents of cell protoplasm; e. g., HgCL probably combines 

 with the proteins, chloroform with the cell lipoids (physicall}'?). By 

 means of his special technic Barber ^^ is able to introduce minute 

 quantities of poisons into living cells and observe their effect on the 

 cytoplasm : ITgCL, is thus found to be most toxic, while ASoO.j is 

 relatively inert. Mathews "- has shown that the toxicity of ions 

 depends on the ease with which they part with their electrical charges, 



ssVerh. Phys. Med. Gesellsch. z. Wiirzburor, inoo. vol. 34. 



59 Wells, Jour. Amer. Med. Assoc. 1006 (46), .341. 



59a The partial protection afforded by a rich carbohydrate diet against the 

 necrogenic action of chloroform, phosphorus and renal poisons, as observed by 

 Opie and Alford (Jour. Exp. ^Med., 1915 (21), 1), may depend on the anti- 

 ketogenic effect of carbolivdrates. 



59b Jour. Exp. Med., inoO (11), 1. 



eoBiochem. Zeit., 1910 (25), 257. 



61 Jour. Infect. Dis., 1911 (9), 117. 



62 Amer. Jour. Physiol., 1904 (10), 290; Nicholl. Jour. Biol. Cliem., 1909 (5), 

 453. 



