446 VICTOR C. MYERS 



the whole blood and corpuscles. From this Bloor suggests: (a) that the 

 blood corpuscles take up the fat from the plasma and transform it into 

 lecithin ; (b) that most, if not all, of the absorbed fat is so transformed ; 

 and therefore (c) that lecithin is an intermediate step in the metabolism 

 of the fats. 



Since the question of the blood lipoids has been very carefully con- 

 sidered by Bloor in a series of papers, an abbreviated table showing his 

 average normal findings and three illustrative pathological (extremely 

 severe) cases is given below. It will be noted in the data on the normals 

 that the lecithin content of the corpuscles is approximately double that 

 of the plasma, while the cholesterol and total fatty acid values are almost 

 always lower in the corpuscles than in the plasma. The value for lecithin 

 in the corpuscles is generally about twice that of the cholesterol, while in 

 the plasma their values are nearly equal. According to Bloor the ratio 

 between these constituents is quite constant in normal blood (especially 

 plasma) and- remains so in most of the pathological samples, suggesting 

 a definite relationship between these constituents, and making it prob- 

 able that cholesterol (as its esters ?) has a part in fat metabolism. 



The most characteristic feature of pathological conditions is the in- 

 crease of total fatty acids and fat both in plasma and corpuscles, and the 

 decrease of lecithin in the plasma. Since the fat is probably to be regarded 

 as the inactive form of the body lipoids, the form in which they are stored 

 and the lecithin as the first step in the utilization, an undue accumulation 

 of fat or a notably decreased value for lecithin, probably indicates a di- 

 minished activity of the fat metabolism. 



In severe diabetes the blood lipoids are all greatly increased but the 

 ratios between those constituents are practically normal. The fact that 

 the cholesterol increases parallel with the fat in diabetic blood, even in 

 severe lipemia, supports the view that probably cholesterol plays an im- 

 portant part in fat metabolism. Since cholesterol may be rather simply 

 estimated it affords a practical method of gauging the severity of diabetic 

 lipemia. In mild diabetes the blood lipoids may be practically normal. 



While there is no certain evidence that the abnormalities in the blood 

 lipoids are responsible for anemia, the low values for cholesterol, which 

 is an antihemolytic substance, and the high fat fraction, which may indi- 

 cate the presence of abnormal amounts of hemolytic lipoids in the blood, 

 are possible causative factors. 



According to Bloor (/) the changes in the blood lipoids in severe neph- 

 ritis are a high fat in the plasma and corpuscles and high lecithin in the 

 corpuscles. These abnormalities are the same as are found in alimentary 

 lipemia and may be regarded as the result of a retarded assimilation of fat 

 in blood, due possibly to a metabolic disturbance brought about by a lowered 

 alkali reserve of the blood and tissues. 



