92 THE ADRENALS AND THE RESPIRATORY BLOOD-CHANGES. 



tubercular disease. The degenerative changes above noted are 

 evidently the same as those that are so commonly to be ob- 

 served in the adrenal epithelium in various diseases." This 

 is probably the only case of hgematoporphyrinuria in literature 

 in which the adrenals were carefully examined. That advanced 

 disease of these organs existed in others is shown by the fre- 

 quency of references to haemorrhage and intraperitoneal blood- 

 effusions associated with morbid phenomena distinctly of supra- 

 renal origin. 



The last point to be determined is the relationship between 

 the haematoporphyrin obtained in laboratories from haemoglobin 

 and that found in the urine. This may be ascertained spectro- 

 scopically. D. Fraser Harris refers to the laboratory pigment 

 as follows: "The acid solution is two-banded, and very charac- 

 teristic; the pigment is iron-free." If we now compare this 

 with the spectroscopic findings of a case of haamatoporphy- 

 rinuria studied by J. B. Ogden 38 the identity of both laboratory 

 and pathological pigments will appear. "The dark urine which 

 was collected on February 12th was examined with the spectro- 

 scope. At first the untreated urine (acid) was used, but with 

 unsatisfactory results, since the two spectral bands of each 

 hasmatoporphyrin could not be made out with certainty. The 

 pigment was then separated from the urine by Salkowski's 

 method and it was found that both the acid and alkaline solu- 

 tions gave the characteristic absorption-bands of haematopor- 

 phyrin." It is thus shown that the haematoporphyrin artificially 

 produced and haematoporphyrin of pathological origin are 

 identically the same. 



What becomes of the free iron? The elimination of this 

 metal by the urine has been demonstrated by Robert and his 

 assistants, Damaskin, Kumberg, Busch, and Steuder, 39 who 

 ascertained that, while the daily elimination in the urine was 

 hardly 1 milligramme in diseases attended by destruction of 

 the blood, this elimination not only increased, but the presence 

 of biliary coloring matter in the urine bore no influence 

 upon this increase. Various authors have demonstrated that 

 it was eliminated in great part by the intestinal tract, the 



88 J. B. Ogden: Loc. cit. 



88 Quoted by H. C. Wood, loc. cit. 



