AMItfOACIDURIA 477 



Huge in a case of primary carcinoma of the liver ; Langstein in a case of 

 jaundice with a stone in the common duct. 



Greco found crystals of leucin in the urine in cases of hepatic cirrhosis. 

 Laache and also von Noorden found leucin and tyrosin in cases of per- 

 nicious anemia. Smith (6) found an abundant sediment of leucin in the 

 urine of a young woman not seriously ill and L have found crystals of 

 tyrosin in the urine of a pregnant patient near term, who passed through 

 a normal delivery and has remained well. 



The presence of these amino acids in the urine, in cystinuria will be 

 considered under that subject. 



The view was formerly held that the appearance of leucin and tyrosin 

 in the urine in cases of grave hepatic disease is due to an inability or 

 diminished ability of the diseased organ to break them down further. 

 However, the fact, which was demonstrated by P. F. Richter(&), that 

 they may occur in the urine in cases of acute yellow atrophy in which there 

 is no marked impairment of urea formation and no conspicuous increase of 

 the excreted ammonia, is opposed to such an explanation. Von Noorden 

 suggested that in acute yellow atrophy leucin and tyrosin might be formed 

 in the tissues as a result of bacterial action, whereas the comparatively 

 small amounts excreted in some cases of phosphorus-poisoning might be 

 derived from the intestine. Impaired destructive power of the liver might 

 be regarded as a contributing factor in both conditions. 



Since Jacobi showed that leucin and tyrosin are formed abundantly in 

 autolysis of the liver under sterile conditions, it has come to be a very 

 general opinion that their presence in the blood, urine, and liver itself, in 

 cases of acute yellow atrophy and phosphorus-poisoning, is due to the 

 breaking down of the parenchyma of the liver. That in both conditions 

 the hepatic parenchyma undergoes extensive destruction admits of no 

 question. 



