506 THE en KM I ST If y of timors 



the ealorimetric finding's were considered in the calculations; nitrogen 

 equilibrium was maintained if sufficient nourishment was obtained 

 and utilized. In general, metabolism iu cancer resembles that of 

 fever, and warrants the assumption of a toxic stimulation of tissue 

 destruction. It is entirely possible that the products of cancer protein 

 destruction are responsible for this toxicogenic metabolic abnormality, 

 since Vaughan has demonstrated that the effects of bacteria and 

 foreign proteins are quite the same in their pyretic and toxic action. 



Salkowski demonstrated that the amount of colloidal nitrogenous 

 material, precipitated from the urine by strong alcohol, is increased in 

 cancer. Numerous observers have corroborated this, but find that a 

 similar condition obtains in other cachectic diseases, although in cancer 

 the amount of colloidal nitrogen seldom is as low as normal unless the 

 tmnor is removed.''* ]\Iuch of this colloidal nitrogen seems to be in the 

 form of "oxy-proteic acid" (Salomen and Saxl),^^ which is a mixture 

 of incompletely oxidized polypeptids, containing much unoxidized sul- 

 phur. The proportion of neutral sulphur in the total sulphur in the 

 urine seems to be increased in cancer (Weiss), but not so constantly 

 or characteristically as to be of diagnostic value.^^ Much clinical in- 

 vestigation has been made of these urinary changes, which has gen- 

 erally substantiated the fact that there usually is more increase in 

 colloidal nitrogen and ethereal sulphate in the urine of cancer than 

 in other diseases, but that in no sense are these changes specific for 

 cancer, and the fundamental metabolic disturbances responsible have 

 not been ascertained.^®^ They seem more indicative of the excessive 

 catabolism of cachexia than of cancer tissue itself. Saxl ^^^ has 

 ascribed part of the increased sulphur elimination to abnormal excre- 

 tion of sulphoeyanid, and as small doses of sulphocyanides lead to 

 increased oxyproteic acid in the urine he suggests that in cancer there 

 is a specific disturbance in sulphoeyanid metabolism, an hypothesis 

 that awaits confirmation. Of similar status is the excessive excretion 

 of glycuronic acid described by Roger. ""- 



Israel, and also Engelmann, have reported the occurrence of a 

 marked increase in the lowering of the freezing-point of the blood in 

 carcinoma (as low as — 0.60° to — 0.63°, the normal being — 0.56°), 

 which they attributed to the presence of excessive products of protein 

 decomposition in the blood. Engel,^" however, found no such increased 

 lowering of the freezing-point in his cases, and questions the signifi- 



!>4See Mancini. Dent. Arch. klin. l\Tod,. I'Ml (103), 288-. Seniciuiw. Folia T'rol., 

 1912 (7), 21.5; de Bloemo et nl., Bioolioin. Zcit.. 1014 (0.5). .34;"). 



»•'•• WicTi. klin. Woch., 1!)11 (24), 440. 



!"! RliuUmiillor and Koscnblooni. .\rcli. Inf. Alrd.. 101:i (12), 27{>; Intorstato 

 Med. Jour., 1916 (23), Xo. 2: bildiojrrapliy. 



f'Oa See Goodridfie and Kaliii. Hioclicni. l^iill.. 10].") (4). US: Damask. ^Vion. 

 klin. Woch., lOl.') (28). 499; Rassa, Biodicni. Zoit.. 1914 ( f)4 ) , 19."). 



n«!b Biodiom. Zoit., 1913 (.'5")). 224. 



oi' P.ull. Soo. :Mpd. Hop.. Paris, 191") (31). 499. 



t'TBcrl. klin. Woch., 1904 (41). 82S. 



