316 RETROGRESSIVE CHANGES 



Jellinek l has studied extensively the cause of death after 

 severe electric shocks, and finds that there are produced intra- 

 cerebral hemorrhages and degeneration of the nerve-cells, which 

 are sufficient to explain the death of the individual without 

 having recourse to the more indefinite idea of " shock/ 7 Cun- 

 ningham 2 considers fibrillary contraction of the heart as the 

 cause of death. 3 



Chemicals cause cell death whenever they are of such a 

 nature as to either coagulate the cell proteids or to destroy its 

 enzymes. The action of such substances as sulphuric acid, 

 strong caustics, etc., hardly calls for explanation. Phenol (car- 

 bolic acid) may cause necrosis and gangrene even when in very 

 dilute solutions ; this appears to be due more to the production 

 of hyaline thrombi of agglutinated red corpuscles in the capil- 

 laries than to direct action upon the cells. In some unpub- 

 lished experiments on the subject of " carbolic acid gangrene," 

 I found this action of phenol very striking when dilute solu- 

 tions were placed on the web of a frog's foot, under the micro- 

 scope ; as soon as the solution penetrated to a capillary, stasis 

 with fusion of the corpuscles occurred in a very few seconds. 

 Similar results have been obtained by Rosenberger. 4 Some 

 poisons seem to cause necrosis without destroying the autolytic 

 enzymes, in which case the cells are rapidly digested ; at least, 

 such a hypothesis seems best to explain the changes seen in the 

 liver in chloroform poisoning, acute yellow atrophy, eclampsia, 

 etc. 5 Not all poisons, by any means, cause cell death tetanus 

 toxin, morphine, and other alkaloids cause death of the indi- 

 vidual as a whole without usually causing primary necrosis of 

 any of the cells. Cell death does not necessarily depend upon 

 destruction of all the cellular enzymes, as has been pointed out 

 previously. Thus, bacteria may be killed by many chemicals 

 which seem not to affect their autolytic enzymes seriously. 



The term, "protoplasmic poison," has been variously used 

 and defined. Kunkel says that a protoplasmic poison " is a 

 poison which, without producing directly evident alterations, 

 harms or kills all living protoplasmic structures." HgCl 2 is 

 such a poison, whereas H 2 SO 4 , bromine, and similar substances 

 that destroy all life through their strong chemical action are not 

 included in this category. The protoplasmic poisons presum- 



1 Virchow's Arch., 1902 (170), 56; Lancet, 1903 (i), 357. 



2 New York Med. Jour., 1899 (70), 581. 



3 Full discussion by Jelliffe in Peterson and Haines' " Legal Medicine and 

 Toxicology," 1903 (1), 245. 



4 Verb. Phys. Med. Gesellsch. z. Wiirzburg, 1900, vol. 34. 



5 Wells, Jour. Amer. Med. Assoc., 1906 (46), 341. 



