CHAPTER XVIII 



PATHOLOGICAL CONDITIONS DUE TO, OR ASSO- 

 CIATED WITH, ABNORMALITIES IN METAB- 

 OLISM, INCLUDING AUTOINTOXICATION 



DUKING the course of metabolism innumerable organic com- 

 pounds are formed, some of which are of a more or less poison- 

 ous nature. As long as the body is in a normal condition, these 

 injurious substances are kept from accumulating in sufficient 

 quantities to do harm ; this is accomplished in one of the fol- 

 lowing ways : (1) Elimination from the body in the urine, feces, 

 etc. ; (2) combination with other substances into harmless, or 

 relatively harmless, compounds ; (3) chemical alteration into 

 compounds that are non-toxic or relatively innocuous. There- 

 fore a harmful accumulation of metabolic products may be the 

 result of any one of the following conditions : 



(1) Failure of elimination because of abnormal conditions in 

 the eliminating organs ; e. g., uremia. 



(2) Failure of neutralization by chemical combination, pre- 

 sumably due to abnormalities in the organs or tissues through 

 whose activities the neutralization is normally accomplished ; 

 e. g.j diseases of the liver. 



(3) Failure in the chemical transformation of the metabolic 

 products; this may result either from abnormalities in the 

 functionating tissues, or through a checking of the normal steps 

 of metabolism by the failure of elimination of the end-products. 



(4) Excessive formation of certain normal products of metab- 

 olism ; e. g.y hyperactivity of the thyroid. 



(5) Production of abnormal toxic chemical substances ; e. g., 

 the intoxication following superficial burns. 



Numerous classifications of autointoxication have been pro- 

 posed by various authors, some excluding from the causes of 

 autointoxication all but the products of metabolism within 

 the blood and tissues of the body, as has been done in the 

 preceding consideration ; many including intoxications caused 

 by the products of gastro-intestinal fermentation and putre- 

 faction ; and still others (v. Jaksch) including even the intoxi- 

 cations produced by bacterial invasion of the body. 1 It is 

 1 See resume' by Weintraud, Ergeb. der Path., 1897 (4), 1. 



431 



