igii] Jacob Rosenbloom 167 



Ottenberg and Gies (52) have found in this laboratory that 

 crude elastose, after its subcutaneous or intraperitoneal injection, 

 can readily be detected in the urine by the heat precipitation test. 

 Since Bence Jones protein has various properties in common with 

 elastoses, Ottenberg and Gies suggested that osseoalbumoid (bone 

 elastin?) might be the forerunner of Bence Jones protein. 



Several years ago, working under the direction of Prof. Gies, 

 I (53) endeavored to determine whether osseoalbumoid might be 

 so acted lipon by the enzymes present in cells of myelomatous 

 growths as to give rise to a substance having the properties of 

 Bence Jones protein. The results of that investigation suggested 

 that Bence Jones protein inay be formed from osseoalbumoid by 

 the action of enzymes present in bone marrow. 



A product of abnormal metabolism. Senator (47) inclined to 

 the view that the Bence Jones protein represents a product of the 

 abnormal metabolism of food protein. Magnus-Levy (11) also 

 thought it was formed from food proteins as a result of altered pro- 

 tein metabolism. As much as 30 to 70 grams of Bence Jones 

 protein may be excreted per day, whereas the total amount of pro- 

 tein in all the tumor tissue seldom exceeds, or indeed equals, this 

 quantity. Magnus-Levy considers it impossible for so much urinary 

 protein to arise from so little tumor tissue. Rostoski (48) 

 advanced the same view. Hopkins and Savory (16) concluded, 

 from studies of metabolism and effects of diet, that Bence Jones 

 protein is a product of endogenous metabolism. 



It is possible that multiple myeloma is due to a specific bacillus, 

 which by the action of its toxins so alters the normal changes occur- 

 ring in bone marrow as to produce this substance from the tissue 

 protein. This idea is strengthened by the analogy Weber has 

 drawn between the characteristics of multiple myeloma and my- 

 cosis fungoides, which is thought by some to belong to the group 

 of infective granulomata. This view is strengthened by the fact 

 that in the case studied by Weber and Ledgingham (46) the growth 

 consisted of plasma cells. The sarcoma-like tumors of the skin, 

 known as mycosis fungoides, have been found to be plasmomata. 

 Another idea that might be held as to its mode of formation is the 

 following: Possibly the columnar epithelium that lines the ali- 



