LEUKEMIA 311 



observed following the therapeutic use of a:-rays in leukemia, which 

 is attributed to the increased autolysis that x-rays are known to pro- 

 (hu'e.'''* According to Kosensterii "*'' the x-rays affect chiefl.v the leuco- 

 genic tissues rather than the adult leucocytes. Lipstein '■"' also found 

 an excessive elimination of amino-acids in the urine of leukemic pa- 

 tients treated by x-rays.**^ According to Curschmann and Gaupp,^- 

 the bk)od of leukemic patients who liave been exposed to x-rays con- 

 tains a specific leucocytotoxin, whicli may be produced by a process of 

 autoimmunization against the leucocytic substance set free by the dis- 

 integrated leucocytes. Capps and Smith ^'^ have obtained similar re- 

 sults. 



Charcot's crystals (also called Charcot-Les'den and Charcot-Xeumann crystals) 

 represent a peculiar and strikino; product of nuclear destruction that has fre- 

 quently been found associated with leukemia. These crystals were first observed 

 by Robin ''4 (1853) in leukemic tissues, but have been named after Charcot, who, 

 with Kobin, described tlieir properties. They were described by Charcot as color- 

 less, retractile, elongated octahedra; insoluble in alcohol, ether, and glycerol; 

 soluble in hot water, acids, and alkalies; size variable, from 0.016 by 0.005 mm. up. 

 These crystals have been found not only in the tissues and blood of cadavers, but 

 also occasionally in the freshly drawn blood of leukemics. Poehl 03 believes them 

 to be the same as Buttcher's spermin crystals, and derived from decomposed 

 nucleins. Schreiner considers that these spermin crystals are phosphoric acid 

 salts of spermin (C2H5X), or, as Majert and Schmidt give it, C^HioN,, with the 



structure HX <;pTT- pTr" > XH, thus being similar to, although not identical 



with, piperazin. The entire question of the composition of spermin is still im- 

 settled,9o however; and it is probable, furthermore, that the crystals found in 

 leukemia are not identical with the crystals observed in semen. 



Crystals that appear similar are also found in asthmatic sputum, empyema, 

 and ascites fluid, bone-marrow, and tumors, and it has been suggested that they 

 are derived from or related to the oxyphile granules of the eosinophiles.9" This 

 view implies an agi'eement with Gumprecht's opinion that the crystals seen in 

 bone-marrow, asthmatic sputum, etc., are not spermin, but of protein nature. 

 As can be seen, the nature and significance of Charcot's crystals are, at the pres- 

 ent time, quite undetermined. 



Summary. — The chemical changes observed in leukemia depend 



ss Radiiim also causes marked metabolic changes in leukemia, with enormously 

 increased excretion of urea, ammonia and total X. and especially of P^0_ ; never- 

 theless tlie increase in uric acid excretion is slight (Ordwav, Knudson and Erdos, 

 Boston :Nred. and Surg. .Jour.. 1917 (176), 490). 



89Miinch. med. Woch., 1906 (53), 1063. 



90 Hofmeister's Beitr.. 1905 (7), 527. 



91 Literature on effects of x-ravs in leukemia, see Arneth. Berl. klin. Wocli., 



1905 (42), 1204: Musser and Eds'all, I'niv. of Penn. Med. Bull.. 1905 '18), 174: 

 Rosenberger. Miinch. med. Woch.. 1906 (53). 209: Williams, Biocheia. Jour.. 



1906 (1). 249; Lossen and IMorawitz, Deut. Arch. klin. Med., 1905 (S3), 288; 

 Koniger, Deut. Arch. klin. Med., 1906 (87). 31. 



92Munch. med. Woch., 1905 (52), 2409. 



93 Jour. Exp. Med., 1907 (9), 51; see also Klieneberger u. Zoeppritz. ^liinch. 

 med. Woch., 190G (53), Xo. 18: Milchner u. Wolfi". Berl. klin. Woch., 1906 (43). 

 No. 23. 



94 Literature given Ijv v. Levden, Festschrift fiir Salkowski. Berlin, 1904, p. 1. 

 95Deiit. med. Woch.. "1895 (21). 475. 



90 Literature, see Hammarsten, Amer. Transl., 1904, p. 420. 



97 Literature, see Floderer, Wien. klin. Woch., 1903 (16), 276; Predtetschcnskv, 

 Zeit. klin. Med., 1906 (59), 29. 



