264 Colchicine 



Colchicine has now been replaced in the treatment of such warts 

 and papillomas by another substance of plant origin, podophyllin, a 

 resin extracted from Podophyllum sp.^''' This substance is a complex 

 mixtine of chemicals, the most active being podophyllotoxin and the 

 peltatins. 1 hese are, quite like colchicine, mitotic poisons, and they 

 interfere mainly with the spindle formation. ""^ The use of the resin 

 of podophyll was known in the United States as a popular medical 

 remedy; it is remarkable that another plant, known in Europe to 

 have good effect on warts, Chelidonium ma jus, contains an alkaloid, 

 chelidonine, which has also been demonstrated to inhibit spindle 

 formation in tissue cultures.^" Chelidonine was advocated for the 

 treatment of cancer at the end of the nineteenth century. 20 



These empirical remedies, probably centuries old, are most in- 

 teresting, and it may be recalled that Dioscorides recommended the 

 use of Ephemeron, a species containing colchicine, in the treatment 

 of some tumors. Colchicine-paste has also jiroved to be successfid in 

 the treatment of some skin cancers of the basal-cell type.^^- i" In 

 ulcerating mammary tumors, interesting results have been obtained. 

 A striking fact is that here again the growth of normal skin appears 

 to be less altered than that of the neoplasm. ^^ 



In hiunan malignant tmnors, the effect of colchicine has so far 

 proved quite disappointing, and from the reports available, it is 

 difficult to understand how it cotdd have been observed to be of any 

 benefit to cancerous patients. ^ It may arrest tumor mitoses in man,^-^ 

 but this effect is never powerful enough to stop the malignant growth. 

 The toxicity of colchicine is redoubtable. Even in a series of four 

 patients, where some favorable eftects were noticed, one case of severe 

 leukopenia was noted, and another patient lost almost all his hair.*^^ 

 In another series, two out of three patients died of agranidocytosis, 

 which was probably the consequence of mitotic inhibition in the 

 bone marrow. 1- 



In severe neoplastic blood diseases, colchicine has also been tried 

 by a few investigators. In lymphoid tumors the results were of no 

 practical interest,^'^ and intramedullary injections did not change the 

 fatal course of acute leukemia.-*^ In chronic myeloid leukemia, a 

 disease which is known to respond favorably to many mitotic poisons, 

 more promising results have been recorded. In one patient, who 

 received 0.5 mg. of colchicine three times and later twice daily, the 

 leukocyte count was found to fall from 110,000 to 2400. This im- 

 provement was only of short diuation.^'^' ^^ 



These data, which are very sketchy, may seem to ride out colchi- 

 cine for the treatment of cancer in man. However, recent develop- 

 ments are more promising, though still in an experimental stage. In 

 Hodgkin's disease, a neoplastic condition affecting mainly the lymph- 



