METMiOLlSM i\ qAycEii 505 



in eaiK'or to i)r()toc't I'orjju.st-lc.s fi-om liemolysis b}- oleic and lactic acid 

 could not be demonstrated by Sweek aijd Fleisher.'*^ 



An extensive review of the literature and methods led Cohnreich **" 

 to the conclusion that resistance of erythrocytes to hypotonic solutions 

 and to poisons vary independently of one another. He has devised an 

 improved method for testing resistance to hypotonic solutions, which 

 seems to vary directly with the' amount of stroma and PO4 content, 

 and finds that determinations of maximum and minimum resistance is 

 of little value, as these concern only a small part of the corpuscles; 

 he therefore determines the "plurinnnn" resistance, involving most of 

 the corpuscles. The most significant results were obtained in cancer 

 of the alimentary tract, in which an increased resistance was always 

 demonstrable. Farmachidis ^^^ finds the cobra venom resistance more 

 specific for cancer than most other investigators. 



(6) Metabolism in Cancer. — Speaking against any specific na- 

 ture in the cause of cancer cachexia are numerous observations, indi- 

 cating that the cachexia is in no way different from the cachexia of 

 other conditions. The behavior of the nitrogen metabolism seems to 

 be quite the same as in tuberculosis and other wasting diseases. There 

 is the same excessive elimination of aromatic substances (phenol, indi- 

 can) and oxyacids (Lewin,^® Blumenthal ^°), which Lewin considers to 

 arise from the abnormal metabolism of proteins, and not from putre- 

 factive decomposition in the tumor or in the intestines. In rats with 

 sarcoma, increased excretion of uric acid and creatin has been ob- 

 served.°°^ There is also the same excessive elimination of mineral 

 salts that is observed in pulmonarv^ tuberculosis, and termed "demin- 

 eralization" by Robin, ^^ but no alteration in the excretion of chlo- 

 rides."^'^ As in other cachexias, the creatin content of the muscles 

 is decreased.''- Fraenkel ^^ finds evidence that there maj' be some diffi- 

 culty in tryptophane metabolism in tumors and in tumor patients. 

 Extensive respiratory studies by "Wallersteiner ^^'^ showed enormous 

 variations in the amount of heat production in different cases, in about 

 10 per cent, of which figures as high as those of severe fevers or 

 exophthalmic goiter were obtained repeatedly; most of the cases 

 showed high normal figures. Nitrogen loss did not ordinarilj^ occur if 



ssJour. Med. Res., 1013 (27). 3S.3. 



88a Folia HematoL, 1913 (16). 307. full bibliography. 



88b Gaz. degli Osped., 1915 (30), fiSO. 



s9Deut. med. Woch., 190,5 (31), 218. 



90 Festschr. f. Salkowski, Berlin. 1904. 

 90aOrdway, Jour. Med. Res., 1913 (23), 301. 



91 Quoted by Lewin, loe. cit. Clowes ct al. (5th Ann. Rep., X. Y. State Dept. 

 of Health. 190.3-4) report observing a slight chloride retention in cancer pa- 

 tients, and review tlie literature of metabolism in cancer. 



9ia Robin. Compt. Rend. Acad. Sci.. 1913 (156), 1262. 



92 Chisholm, Riocliem. Jour., 1912 (6), 243. 



93 Wien. klin. Woch., 1912 (25), 1041. 

 93aDeut. Arch. klin. Med., 1914 (116), 145. 



