THE RELATIVE REACTION WITHIN LIVING MAMMALIAN TISSUES : VI. FACTORS DETERMINING THE REACTION OF SKIN GRAFTS; A STUDY BY THE INDICATOR METHOD OF CONDITIONS WITHIN AN ISCHEMIC TISSUE.

By means of vital staining with indicators a study has been made of the changes in reaction and in certain other attributes of a tissue abruptly rendered ischemic. Grafts of mouse skin have been employed as test material. It has been found that almost at once after implantation vigorous grafts become notably acid as compared with the normal skin and that they survive and "take" despite the acid condition, which remains at a maximum for several days. Weak or injured grafts on the contrary tend to be as alkaline as their surroundings, if not more so. Through experiments directed to the purpose reasons for this difference have been found in the lessened metabolic activities of the cells of the injured skin, and in an increased permeability which leads to a generalized suffusion of the damaged tissue with the alkaline lymph and an abnormally rapid escape of carbon dioxide from it. The influence of these factors to determine the reaction of tissues dying within the body has not been sufficiently taken into account in considering the chemical changes that occur after cell death, and some revision of current views regarding these as they affect small necrotic masses would seem called for. Carbon dioxide penetrates so readily into the living skin as to cause some local increase in the hydrogen ion concentration within cutaneous regions exposed to an atmosphere of it, even when the local circulation and the ventilation by way of the lungs have not been interfered with. It penetrates injured skin with especially great ease. Tissue acidosis and edema not infrequently occur together; but no relationship between them of cause and effect has been made out.