C PI A P T K R X AM 1 I 



PATHOLOGICAL CONDITIONS DUE TO, OR ASSOCI- 

 ATED WITH, ABNORMALITIES IN METABOLISM, 

 INCLUDING AUTOINTOXICATION 



During the course of metabolism innumerable organic compounds 

 are formed, some of which are of a more or less poisonous nature. 

 As long as the body is in a nonual condition, these injurious sub- 

 stances are kept from accumulating in sufificient quantities to do 

 hann; this is accomplished, in one of the following ways: (1) elimi- 

 nation from the body in the urine, feces, etc.; (2) combination with 

 other substances into harmless, or relatively harmless, compounds; (3) 

 chemical alteration into compounds that are non-toxic or relatively 

 innocuous. Therefore a harmful accumulation of metabolic products 

 may be the result of any one of the following conditions : 



(1) Failure of elimination because of abnormal conditions in the 

 eliminating organs ; e. g., uremia. 



(2) Failure of neutralization by chemical combination, presumably 

 due to abnormalities in the organs or tissues through whose activities 

 the neutralization is normally accomplished; e. g., diseases of the 

 liver. 



(3) Failure in the chemical transformation of the metabolic prod- 

 ucts; this may result either from abnormalities in the functionating 

 tissues, or through a checking of the normal steps of metabolism by 

 the failure of elimination of the end-products. 



(4) Excessive formation of certain normal products of metabolism; 

 e. g., hyperactivity of the thyroid. 



(5) Production of abnormal toxic chemical substances; e. g., the 

 intoxication following superficial burns. 



Numerous classifications of autointoxication have been proposed by 

 various authors, some excluding from the causes of autointoxication 

 all but the products of metabolism within the blood and tissues of 

 the body, as has been done in the preceding consideration ; many in- 

 cluding intoxications caused by the products of gastro-intestinal fer- 

 mentation and putrefaction; and still others (v. Jaksch) including 

 even the intoxications produced by bacterial invasion of the body.^ 

 It is extremely difficult to draw the line as to just what should be 



1 See resume by Weintraud, Ergeb. der Path., 1897 (4), 1. 



523 



