352 RETROGRESSIVE PROCESSES 



practically identical substance is formed in all tissues and in all 

 species of animals, even when the cause is quite different. 

 Whether the precursors are brought to the organ in solution, 

 or in leucocytes, is unknown probably the former. The 

 hypothesis that amyloid is formed from disintegrating red cor- 

 puscles is probably incorrect. It is also quite certain that it is 

 not of bacterial origin, for amyloidosis has been produced by 

 chronic intoxication with aseptic materials (rennin), 1 and it is 

 also produced by the most varied species of bacteria and by 

 their toxins, although the staphylococcus is usually most effective 

 in experimental work. 2 Neither is suppuration absolutely essen- 

 tial, for injection of toxins alone (e. g., in preparing diphtheria 

 antitoxin 3 ), without suppuration, may produce amyloidosis, as 

 also frequently do syphilis without suppuration and, less often, 

 many other non-suppurative conditions (e. g., tumors). 



I/ocal amyloid accumulations 4 are of some interest in 

 considering the genesis of the usual generalized form. They 

 occur particularly as small tumors in the larynx, bronchi, nasal 

 septum, and eyelids ; as all these tissues are normally rich in 

 chondroitin-sulphuric acid, it seems probable that the amyloid 

 arises from a local overproduction of chondroitin-sulphuric 

 acid, which becomes bound with proteids in situ. This makes 

 it seem more probable that, in spite of the lack of positive 

 experimental evidence, general amyloidosis is due to liberation 

 of excessive quantities of chondroitin-sulphuric acid in the 

 sites of tissue destruction. 



Another form of local amyloid is seen particularly in the 

 regional lymph-glands of suppurating areas ; e. g., the lumbar 

 glands in vertebral caries, the axillary glands in shoulder-joint 

 suppuration. This local amyloidosis is undoubtedly due simply 

 to the fact that these glands receive first, and in largest amounts, 

 the cause, whatever it may be, of the amyloid production. 5 



Corpora amylacea will be found discussed under "Concre- 

 tions" (Chap. xv). 



1 Schepilewsky, Cent. f. Bakt, 1899 (25), 849. 



2 In a series of experiments directed to ascertain, if possible, which constitu- 

 ent of pus might be the cause of amyloid formation, I was unable to secure 

 amyloid by protracted intoxication of rabbits by Witte's "peptone," which 

 consists chiefly of proteoses (Trans. Chicago Path'Soc., 3903 (5), 240). 



3 Zenoni, liiforma Med., 1901 (2), 698. 



4 See Edens, Virchow's Arch., 1905 (180), 346. 



5 Quite unexplained is the cause of the rarely observed localization of 

 amyloid in the wall of the urinary bladder. See Lucksch (Verh. Deut. path. 

 Gesell., 1904 (7), 34). 



