THE BLOOD IN CANCER SUBJECTS 267 



ily and rapidly to clinical recovery with apparent entire regression 

 and disappearance of the tumor, so far as could be determined 

 by palpation. The case was supposed to be hopeless by the sur- 

 geon who attempted the operation; yet progress was so spectac- 

 ular under the protein treatment (exclusively) that a few weeks 

 later the patient returned to his home and took up once more his 

 accustomed work as a practising physician. 



Such a reduction in the red blood corpuscles under the Proteal 

 treatment as that just noted would be regarded with equa- 

 nimity, however, only where there was, as in the instance cited, a 

 large tumor mass undergoing rapid disintegration. And even then, 

 it is questionable whether, as a rule, it would be desirable to carry 

 forward the disintegration of the tumor mass so rapidly as to 

 produce a marked reduction in the red blood corpuscles. A bet- 

 ter way, ordinarily, would be to regulate the dosage so as to 

 secure only such amount of hydrolysis of cancer cells as can be 

 dealt with by the red blood corpuscles without reducing their 

 ranks much below the five-million mark. 



Cases are reported where the dosage of proteins was pressed 

 so actively from the outset that the breaking down of a pelvic 

 cancer was effected so rapidly that the system could hardly have 

 been expected to withstand the shock had there not been oppor- 

 tunity for exterior discharge and drainage. One physician de- 

 scribed the results attained in such a case as reminding him of 

 the effects of a curette, so rapid was the removal by exfoliation 

 of the cancer tissue. 



In such a case, there is obvious danger of severe hemorrhage. 

 This danger would be obviated, at least in a measure, if the dosage 

 were so regulated that the decompounding of the cancer cells was 

 less rapid. 



I have elsewhere pointed out that the critical period in the 

 treatment of cancer cases comes after an interval of several 

 weeks, when the systemic response has been carried to the maxi- 

 mum. Almost invariably, the question then arises as to the best 

 manner of continuing treatment, in order that the effects may be 

 cumulative, and the case carried to the favorable termination that 

 seemed promised by the early response. 



It is now that constant appeal should be made to the microscope 

 to determine the precise status of the red blood corpuscles and 

 the various leucocytes. An endeavor should be made to keep the 

 former as near as possible to the five-million mark ; while it is to 

 be hoped that the lymphocytes will continue to represent at least 

 one-third of the leucocyte count, and that the large mononuclears 

 will outnumber the small ones. 



A typical satisfactory blood count is shown by patient number 

 239 (carcinoma of the breast), whose blood on the 8th of Janu- 



