INFLUENCE OF ROENTGEN RAYS UPON METABOLISM 885 



cytc count, at the same time there was a slight fall in the basal metab- 

 olism. 



Radium has been found to have a similar effect upon the nitrogenous 

 metabolism in leukemia as do x-rays. Knudson and Erdos in a case of 

 myelogenous leukemia treated by surface application of radium observed 

 in each of the three series of treatments marked changes in metabolism. 

 The total nitrogen, urea, ammonia and phosphates are immediately in- 

 creased and reach a maximum in about seven days after each application. 

 The uric acid excretion also increased some the first seven days and then 

 remained at about the same level throughout the observations. An exam- 

 ination of the uric acid in the blood at relatively long intervals during the 

 treatment showed little change. In another case of myelogenous leukemia, 

 Ordway, Tait and Knudson obtained results in conformity with the case 

 described above. An examination of the blood for creatinin and non- 

 protein nitrogen before, during and immediately following radium treat- 

 ment shows that there is apparently no change during the radiation. 



Martin, Denis and Aldrich have studied the chemical changes in the 

 blood following Roentgen ray treatment in leukemia. In the more severe 

 cases they found the non-protein nitrogen was high and after treatment 

 a gradual but steady fall was noted. The creatinin was not affected. The 

 uric acid content was much increased but a large diminution in the num- 

 ber of white cells which occurred as a result of treatment caused no ap- 

 preciable decrease in this constituent. 



The iron metabolism in myelogenous leukemia before and after expos- 

 ure to x-rays has been studied by Bayer (6). He found that isolated ex- 

 posure of spleen to x-rays causes an absolute increase in iron excretion in 

 the feces greater than in the isolated exposure of the long bones. The iron 

 excretion in pathological conditions of the spleen is greater after exposure 

 to x-rays than in* the normal. 



The chemical changes observed in the treatment of leukemia with x-rays 

 and radium apparently depend upon the excessive quantity of leucocytes 

 and lymphoid tissue, which undergo processes of disintegration during 

 treatment, with the result that products of nucleoprotein destruction (total 

 nitrogen, uric acid, purine bases, and phosphates) appear in the urine in 

 increased quantities. 



The use of radium in the treatment of gout directed early the attention 

 of investigators to the influence of radium on uric-acid metabolism. As a 

 result of the investigations in His' clinic it was affirmed that uric acid 

 occurs in the blood in gout in a specially insoluble modification and that 

 under the influence of radium the insoluble pathological form of uric acid 

 becomes changed to a more soluble physiological form which is easily 

 destroyed and excreted ; the net result being a rapid solution of the gout 

 tophi, an increased elimination of uric acid in the urine and a disappear- 

 ance from the blood (Gudzent and Lowenthal, Gudzent(a)(6)(eZ)). 



