HEMOGLOBIN PRODUCTION FACTORS IN THE HUMAN LIVER : II. LIVER DEGENERATION, CANCER, CIRRHOSIS AND HEPATIC INSUFFICIENCY

Biological assay of human liver material shows various concentrations of hemoglobin producing material in various diseased states. Cardiac congestion with red atrophy of the liver shows values (Table 21) somewhat below the human normal—94 per cent compared to 162 per cent. It is probable that this is due to atrophy and destruction of the liver cells in the centers of the liver lobules. We believe the remaining liver cells have a normal content of hemoglobin producing factors. Amyloid (tuberculosis) and fatty (alcoholic) degeneration show (Table 22) subnormal values—111 per cent compared to 162 per cent. If we allow for the "dilution" of liver cell weight by the amyloid and fat we observe normal values for the concentration of hemoglobin producing factors. Carcinoma growth in the liver whether primary or secondary shows net figures (Table 23) which are low—75 per cent compared to normal 162 per cent. It appears that cancer tissue, even tumor cells originating from hepatic epithelium, contains no hemoglobin producing factors. If we allow for the "dilution" of the remaining liver cells by the cancer tissue the figures are within normal limits. Cirrhosis and hepatitis (Table 24) with no signs of true hepatic insufficiency or severe hepatic injury but death supervening from secondary infection or hemorrhage will give average normal values –164 per cent compared to normal human of 162 per cent. Icterus is not a factor. Cirrhosis or hepatitis with severe parenchyma injury and signs of hepatic insufficiency give low values (Table 25) in biological assay –48 per cent compared to normal human 162 per cent. It may be surprising that the liver cells hold so tenaciously to these unknown factors influencing hemoglobin production but obviously only in severe liver injury is this concentration seriously reduced.