Experimental Liver Necrosis; Iii. Nitrogenous Metabolisms

1. In focal and diffuse necroses of the liver due to haemotoxic sera there occurs an increased elimination of total nitrogen with a corresponding augmented output of urea. The ammonia excretion becomes slightly diminished at first, but later rises somewhat above normal. The undetermined nitrogen is markedly increased. 2. In diffuse degeneration with no necrosis on the other hand only a slightly increased output of total nitrogen is evident. A rearrangement of the urea-ammonia proportion occurs in that the ammonia excretion is augmented while the urea elimination is correspondingly diminished. The undetermined nitrogen rises but little. 3. In control experiments with normal serum no effect is produced. 4. These results would appear to indicate that in lesions characterized by uniform degeneration of the liver parenchyma, in contradistinction to necrosis, there occurs no increased nitrogen elimination but merely a disturbance of the urea-forming function of the cell without the appearance in the urine of products of autolysis. On the other hand in necrosis, of even considerable extent, the total-nitrogen is greatly augmented, as is also the rest-nitrogen; while the production of urea, on account of the persistence of normally functioning liver cells, remains relatively unchanged. This "factor of safety"(32) possessed by the liver is, we think, one of the most important results brought out in this investigation and must be given great weight in any consideration of the chemistry of hepatic disturbances.