HEMOLYSIS IN CANCER 509 



products of foreign proteins which may produce "protein fever" 

 and other toxic effects. It has often been observed that when ex- 

 tensive necrosis is produced in experimental tumors in rats and mice 

 the animals may show profound toxemia, presumably because of 

 absorption of autolytic products. 



Since all normal tissue-cells produce substances through their me- 

 tabolism that enter the circulation, it is quite certain that tumor-cells 

 do likewise, and it is highly probable that the presence of abnormal 

 quantities of such products, even if they are of quite normal compo- 

 sition, may cause disturbances in the body. As yet, however, no such 

 substances, either normal or abnormal, have been isolated, nor has 

 their presence been demonstrated. Numerous isolated observations 

 of ptomains or similar substances in the urine of cancer patients may 

 be found in the literature,- but their importance is extremely question- 

 able. A large proportion of cases of malignant tumors exhibit renal 

 injury (Kast and Killian)^ but whether from products of the tumor o? 

 from bacterial infection has not been determined. 



Hemolytic Substances. — -A number of observers have described the 

 finding of hemolytic substances in cancer extracts. Bard^ observed 

 that in hemorrhagic carcinomatous exudates in serous cavities the 

 blood is rapidly hemolyzed, which is not the case in exudates from 

 other causes, but this was not corroborated by Weil.^ Kullmann^ 

 found that extracts of carcinomas contain hemolytic substances acting 

 energetically both in the body and in vitro; these are soluble in alcohol 

 and in water, are not complex in composition, are not specific for hu- 

 man corpuscles, but are toxic for all varieties of corpuscles. Micheli 

 and Donati*"' likewise found hemolytic substances in 8 of 15 tumors, 

 of which 5 acted on all varieties of corpuscles, and 3 acted on only 

 certain varieties; they regard the hemolytic substances as the products 

 of autolj^sis in the tumors. WeiF also found the hemolytic property 

 of tumor extracts to vary with the amount of necrosis, and to depend 

 on dialyzable hemolytic substances distinct from the hemolysins 

 of normal tissues. It is well known that among the products of 

 autolysis of normal tissues are hemolytic substances. Whether the 

 severe anemia frequently present in carcinoma is due, either largely 

 or in part, to these products of autolj^sis is unknown, but it is very 

 probable that they have some effect. 



Hemolysis in Cancer.^ — The blood serum of cancer patients has 

 often a hemolytic action on the corpuscles of normal persons (Crile), 

 but this property is quite inconstant, being present in 67 per cent, of a 

 series of 472 cancer cases collected by Krida, while 15 per cent, of 



2 See KuUmann, Zeit. klin. Med., 1904 (53), 293. 



3 Proc. See. Exp. Biol. Med., 1919 (16), 141. 

 * La Semaine M6d., 1901 (21), 201. 



5 Jour. Med. Res., 1910 (23), 86. 



6 Riforma Med., 1903 (19), 1037. 



^ Jour. Med. Res., 1907 (16), 287. 



