In an earlier study (1) an attempt was made to determine whether there might be a demonstrable biochemical abnormality in skin prepared for the Shwartzman phenomenon. Investigation of the carbohydrate metabolism of such prepared skin sites revealed the presence of a striking and consistent deviation from normal, in the form of a pronounced degree of aerobic glycolysis. As a result of this atypical form of glucose utilization, such skin sites contain large amounts of lactic acid. It was suggested that the ultimate blood vessel disruption might be due to the action of proteolytic enzymes or "cathepsins," and it was pointed out that the occurrence of aerobic glycolysis provided local conditions favoring the action of such enzymes. Evidence was subsequeutly presented (2) to indicate that the observed aerobic glycolysis in prepared skin sites was largely due to the influx of exudate polymorphonuclear leucocytes, rather than to a direct alteration of the metabolism of intrinsic skin elements by the intradermally injected toxin.In the present study, attention was turned to the changes which occur following the intravenous challenging injection, in an effort to ascertain the nature of the mechanisms involved in the final blood vessel damage and the production of hemorrhagic necrosis. Evidence will be presented to indicate that the capillaries and veins in skin areas prepared for the Shwartzman phenomenon exhibit a marked vulnerability to a peculiar sort of cellular thrombosis induced by the challenging injection. The resulting damage to the involved blood vessels and the surrounding tissue elements constitutes a type of tassue damage which, it is believed, has not been previously described.
Materials and MethodsAniraals.--Hybrid male and female rabbits, weighing 1500 to 2000 gin., from the Rockefeller Institute stock were used throughout the experiments. Litter-mate controls were used