PATHOLOGICAL METABOLISM OF THE BLOOD 593 



been made of the more recent chemical methods of blood analysis to the 

 study of the level of the nitrogenous and other metabolites in the blood 

 of patients suffering from anemia and leukemia. The few observations 

 which have been recorded are of great interest because of the possible 

 light which they may throw upon the problems of protein metabolism 

 from the standpoint of blood and tissue analysis as well as upon the 

 influence of splenic function on the fat and lipoid content of the blood. 



The latter problem, as was pointed out, is closely linked with the 

 influence of cholesterol and the unsaturated fatty, acids in changing the 

 conditions of hemolysis after splenectomy. 



The level of the nitrogenous constituents of the blood in anemic and 

 in leukemic states has been determined by only a very few observers. 

 Following hemorrhage in animals, Taylor and Lewis, and Buell(a) noted a 

 rise in the non-protein nitrogen of the blood. The excessive tissue pro- 

 teolysis to which hemorrhage may give rise has already been commented 

 upon; and it is to this factor that these observers are inclined to at- 

 tribute the increase of this fraction in the blood in acute posthemorrhagic 

 conditions, the breaking down of body protein being, in a measure, com- 

 pensatory so as to bring about a replacement of the lost circulating pro- 

 tein. 



In her studies on the influence of splenectomy on metabolism in ane- 

 mia, Denis(6?) records observations on the non-protein nitrogen of two pa- 

 tients with pernicious anemia and on one with "family jaundice." All of 

 these showed practically normal values for this fraction both before and 

 after splenectomy. In leukemia, however, Martin and Denis found a 

 high non-protein nitrogen in the blood. 



Of the other components, urea and amino nitrogen were also found 

 to be increased in acute posthemorrhagic anemia, and uric acid markedly 

 so in leukemia (Folin and Denis (d)). 



The studies of Eppinger and of King on the blood fat of normal and 

 splenectomized animals has already been referred to in the paragraphs 

 on the regulatory function of the spleen in blood formation and deltruc- 

 tion. These workers, it was pointed out, found after removal of the 

 spleen, an increase in the total fats and cholesterol of the blood, and 

 a decrease in the unsaturated fatty acids, findings which, on the whole, 

 have not been confirmed by other observers. Thus Dubin and Pearce 

 found the total fats and the unsaturated fatty acids practically the same 

 both before and after removal of the spleen, an observation which agrees 

 with that of Denis (cf), who noted no change in the total fatty acids of the 

 blood in different forms of anemia. 



Determinations of the cholesterol content of the blood possess espe- 

 cial interest in experimental and clinical anemias characterized by he- 

 molysis. A decreased blood cholesterol has been found by Dubin in ex- 

 perimental trypanosome anemia and by Bloor(fc), Denis(rf) and Gorham 



