DESTRUCTION OF THE RED BLOOD CORPUSCLES IN HEALTH AND DISEASE

Abstract

The subject of blood destruction has almost as many ramifications as the blood stream itself; and in entering upon it one must choose a path or perhaps be lost amid data. In the present instance an effort will be made to follow out the physiological processes involved in the fate of the cells, with incidental digressions only for the multifarious agents causing cell injury, and the innumerable consequences thereof. THE EVIDENCE FORANORMAL DESTRUCTION OFBLOOD. So subtly is normal blood destruction conducted and the remains of the cells disposed of that were it not for indirect evidence one might suppose the life of most red corpuscles to endure with that of the body. But this evidence is convincing. The continuous activity of a broadly distributed hema-topoietic tissue; the daily excretion through the bile of a pigment nearly if not precisely identical with one of the pigmented derivatives of hemoglobin (220), (221) ; the appearance of this derivative in old hema-tomas (224) and in the plasma after hemoglobin injection and liver exclusion (236) ; the apparently significant association of hemoglobin and bilirubin throughout the animal kingdom (143) ; the existence here and there in the healthy organism of cells containing erythrocytes in various stages of disintegration; and, not least, the delicate structure of the red cell itself, its lack of a nucleus, the incessant squeezing and buffeting to which it is subjected,-these and other facts clearly prove that blood destruction must be one of the routine tasks of the body. Yet this statement of the case would be one-sided without a mention of the corpuscle’s notable aptitude for the existence that it has to lead. Chemical wear and tear are practically negligible in it, as shown by the fact that it uses up almost no oxygen (133), (134), (82) ; it is almost devoid of autolytic ferments (159), (188)) (189), (162) ; the corpuscular tissue is so constituted as to withstand sudden and considerable changes in the tonicity of the surrounding medium, such as the cell may not in-frequently have to encounter; and while yielding is yet so resilient that the disc shape is retained although the cell is forced over and over