490 



Jones' protein. The result of that investigation suggested that Bence- 

 Jones' protein may be formed from osseoalbumoid by the action of 

 enzymes present in bone-marrow. 



A Product of Abnormal Metabolism. Senator inclined to the view 

 that the Bence-Jones' protein represents a product of the abnormal 

 metabolism of food protein. Magnus-Levy also thought it was formed 

 from food proteins as a result of alter protein metabolism. As much as 

 30 to 79 gm. of Bence-Jones' protein may be excreted per day, 

 whereas the total amount of protein in all the tumor tissue seldom exceeds, 

 or indeed equals, this quantity. Magnus-Levy considers it impossible for 

 so much urinary protein to arise from so little tumor tissue. Rostoski 

 advanced the same view. Hopkins and Savory concluded, from studies 

 of metabolism and effects of diet, that Bence-Jones' protein is a product 

 of endogenous metabolism. 



It is possible that multiple myeloma is due to a specific infectious agent, 

 which by the action of its toxins so alters the normal changes occurring in 

 the bone-marrow as to produce this substance from the tissue proteins. 

 This idea is strengthened by the analogy Weber has drawn between the 

 characteristics of multiple myeloma and mycosis fungoides, which is 

 thought by some to belong to the group of infective granulomata. This 

 view is stimulated by the fact that in the case studied by Weber and 

 Ledingham the growth consisted of plasma cells. The sarcoma-like tumors 

 of the skin, known as mycosis fungoides, have been found to be plasmomata. 

 Another idea that might be held as to its mode of formation is the follow- 



TABLE I. LOW PROTEIN DIET. 

 URINARY NITROGEN 



PER CENT IN TOTAL NITROGEN 



