PATHOLOGICAL METABOLISM OF THE BLOOD 601 



followed by a reduction in the elimination of uric acid, iron, and urobilin, 

 changes which point to diminished blood destruction. 



Rontgen-Rays and Radium. It is now generally accepted that 

 the rontgen-rays and radium are practically identical in their effect upon 

 the tissues and the biochemical processes of the body. As a result of the 

 careful histological studies of Heinecke, Warthin(a), and Proescher and 

 Almquest, as well as those of a number of other observers, it has been 

 established that both forms of radiant energy exert a destructive action 

 on the entire hemopoietic system, and more especially upon the lymphatic 

 tissues and the bone-marrow. All of the white blood-cells, both in the 

 circulation and in the blood-forming organs, are attacked, the effect being, 

 however, particularly selective for the cells of the lymphocytic series 

 (Taylor, Witherbee and Murphy). And so far as the rontgen-rays are 

 concerned, it has been found that their action is essentially the same in 

 patients suffering from leukemia as in normal individuals (Aubertin, 

 Warthin(6)). 



The effects produced by radiation upon the metabolic processes of 

 normal animals and of patients, treated for disorders other than those 

 of the blood, are in many respects similar, although not so striking, to 

 those noted in leukemia. Animals exposed for shorter or longer periods 

 to the action of the rontgen-rays show, in most instances, an increased 

 elimination of total nitrogen, uric acid, purin bases, and phosphorus 

 (Quadrone, Benjamin and von Reuss, Lommel (&) ). The level of urinary 

 nitrogen in sucli animals may at times rise to from 50 to 100 per cent 

 above the normal base line, this rise being accompanied by a high non- 

 protein nitrogen of the blood, which may increase to twice or three times 

 the normal on the day before death (Hall). 



Many observers have called attention to the fact that the rontgen- 

 rays and radium are capable also of producing changes in the metabolism 

 of individuals, suffering from affections other than blood diseases. Thus 

 Edsall and his associates have demonstrated that a great destruction 

 of tissue may follow exposure to the rontgen-rays in certain nutritional 

 disorders, and Bloch, who studied the metabolism of a patient treated 

 for chronic eczema, noted that the rays caused an increase in the output 

 of uric acid, purin bases and phosphorus pentoxid in the urine. Similar 

 results were obtained by Linser and Sick on five patients under rontgen 

 treatment for various skin diseases. All of these patients showed, besides 

 the increase in the total urinary nitrogen, to which attention had been 

 previously directed by Baermann and Linser, also a marked rise in the 

 output of uric acid and purin bases. Analogous changes in metabolism 

 following the use of radium have been described by Kikkoji, who found 

 a significant rise in the basal metabolism, as well as an increased elimi- 

 nation of total nitrogen and uric acid in a normal individual and in 

 one suffering from chronic arthritis. Far more striking, however, are 



