2l8 MALIGNANT TUMORS 



i per cent, solution of sodium fluoride. The sodium fluoride solution is first neutralized 

 (alizarin as indicator) until the violet color is reduced to its minimum. The cell emul- 

 sion may be thus preserved for several weeks. 



In the test, the carcinoma extract is diluted with 0.6 per cent, sodium chloride solu- 

 tion until it becomes opalescent. To 3 c.cm. of this emulsion are added 10 drops of 

 the patient's serum preferably fresh and active. They are allowed to remain at 40 C. 

 for 24 hours and the test is positive if the turbidity persists. Control tubes must be 

 made of the serum alone, carcinoma extract without serum, and carcinoma extract 

 with normal serum. The last should become clear. 



Recently Freund and Kaminer proposed the following more delicate modification. 

 The supernatant fluid from the emulsion of carcinoma cells is mixed with acetic acid 

 (5 c.cm. of acid to 100 c.cm. of fluid) heated in the water bath for one-quarter of an hour 

 at 80 C., filtered, and after cooling neutralized with sodium bicarbonate against litmus. 

 Then it should again be heated and filtered. Boiling or heating over the free flame is 

 to be avoided. An extract can also be made by heating the tumor itself (preserved in 

 alcohol) in 0.25 per cent, of acetic acid, then filtering and neutralizing. Serum of 

 cancerous individuals added to this extract produces a cloudiness; non-cancerous 

 serum and extract remains clear. Freund and Kaminer advise that both the cell- 

 counting method and the turbidity reaction should be applied to each serum, one 

 acting as a control upon the other. 



Ranzi and Admiradzibi, Kraus and Graff have corroborated Freund 

 and Kaminer's findings. Rosenberg working under Citron's guidance has 

 found that although in the main the reaction is obtained as above quoted, 

 some carcinoma sera give a negative reaction and some non-carcinoma 

 patients (tuberculosis, pregnancy) give a positive result. 



The Meiostagmine Reaction. 



Weichard showed that by bringing together antigen and antibodies in 

 certain dilutions, the rapidity of diffusion is increased (epiphanin reaction). 

 M. Ascoli further demonstrated that the union between a specific antigen 

 and its specific serum is associated with appreciable lowering in the surface 

 tension, so that the number of drops to a definite quantity of fluid is dis- 

 tinctly increased (Meiostagmine reaction). This term is of Greek deriva- 

 tion, "paw," smaller, "o-ray/wx," drops. Traube's "Stalagmometer" 1 

 measures the number of drops. 



The meiostagmine reaction has been tested by Izar and Vigano in 

 typhoid, paratyphoid and lues and found to possess a certain degree of 

 specificity. In tuberculosis, the test is positive only in active cases. 

 Ascoli and Izar claim to get reliable results with their method also in car- 

 cinoma. Their technique is as follows: 



1 The Stalagmometer of Traube is merely a very finely and elaborately graduated 

 pipette with a central bulbous reservoir. The dropping end of the instrument ends 

 in a flattened ground base thus insuring uniformity in the size of the drops. The 

 instrument is so graduated that a fraction of a drop can be estimated. 



