546 Aii\oiniMJTii:s /.v metauolism 



but SloAvtzoff ^* found both peroxidase and protease decreased, and 

 iitti-ibutcd tlie increased autolysis to a g'reater acidity of the liver. 



The Blood. — In the blood marked changes are found, one of the 

 most prominent, besides the icterus, being the decreased coagulability 

 of the blood. This seems due to a loss of fibrinogen, ^^ wliich, with 

 the giobuliu, is greatly decreased, the albumin remaining less al- 

 tered.^® The fibrin-ferment also seems to be decreased. These 

 changes may be due to direct autolysis of the blood constituents (Ja- 

 coby having found that thrombi become rapidly dissolved in phos- 

 pliorus-poisoning) or to the changes in the liver. The icterus de- 

 pends apparently upon lesions of the finest bile capillaries,^^ although 

 there is also some increase in hemolj-sis, and a decrease in the total 

 blood and all its elements (Welsch) ; ^^ and both bile salts and pig- 

 ments appear in the urine. In all these diseases with marked liver 

 changes there is an increase in the lipase of the blood. ^^^ Neuberg 

 and Richter ^^ have analyzed the blood drawn during life from a pa- 

 tient with acute hepatic atrophy, and isolated from 355 c.c. of blood 

 0.787 gm. tyrosine, 1.102 gm. leucine, and 0.240 gm. of lysine ; they 

 estimated the amount of free amino-acids in the entire blood to be 

 about 30 grams. This amount is so large that they question the pos- 

 sibility of it all arising from the degenerated liver tissue ; but more 

 analyses are necessary before conclusions on this point can be drawn,-*' 

 especially by the use of the newer methods. Certainly in dogs suf- 

 fering from ehlorofomi necrosis of the liver or phosphorus poisoning 

 the amount of free amino acids in the blood and urine is usually very 

 small. -"•■' 



Origin of the Amino=acids. — The earliest conception of the source 

 of the leucine and tyrosine found in the urine was that it came from 

 the products of tryptic digestion absorbed from the intestinal tract, 

 which the liver could not convert into urea because of its damaged 

 condition. On the demonstration by Jacoby -^ that these same bodies 



i4Biocliom. Zcit., mil (31). 227. 



1^' Whipple and ITurwitz (Jour. Exper. IVled., 1011 (l:^). i:}(i) find a <,noat 

 (IccToase in fi1)rinof;on during experimental cliloroforin necrosis of the liver. 



i''.Jacobv, lor cit.; see also Doyon, C'ompt. Rend. Soc. Biol., 1!M(.") (.IS). 403; 

 and 1900, Vol. 06. 



1" Lang (Zoit. exp. Path., 1006 (3), 473) found fihrinogen in the liih" of a 

 dog poisoned with phospliorus, which may account for the oeel\isien of the 

 bile vessels and tlie resulting jaundice. 



18 Arch. int. Pharm. et Ther.', lOO.") (14), 107. 



i«a Whipple et al.. Pull. Johns Hopkins ITosp., 1013 (24), 207 and 357. 

 Quinan found the lipase content of liver tissue much reduced in chlorofium 

 necrosis (.Tour. ^led. Res., 1015 (32), 73). A review of work- |)uhlished on blood 

 dianges and liver fuTiction in phosphoiMis and cliloroforin ]ioisoninL; is <^iveii by 

 ^^arshalI and liowntree, Jour. Exp. Med.. 1015 (22), 33;i. 



ii'Dcut.med. Woch., 1004 (30), 400. 



20 V. Bergmann (llofnieister's l^eit., 1004 (6), 40) was able to isolate 2.3 grams 

 of amino-acids combined with the chloride of naphthalene sulplioiiic arid, from 

 270 c.c. of blood in a case of acute vellow atrophv. 



■iOaSee Van Slvke, Arch. Int. IMed., 1017 (10)," 77. 



21 Zeit. physiol. Chcm., 1000 (30), 174. 



