12 



Senator and Noel-Paton incline to the view that the Bence 

 Jones protein represents an abnormal product of the metab- 

 olism of the protein of the food. Magnus- Levy also thinks 

 it is formed from the food proteins as a result of altered pro- 

 tein metabolism, because as much as 3070 grams of the sub- 

 stance per day may be excreted whereas the total amount 

 of protein in all the tumor tissue seldom exceeds, or indeed, 

 equals this quantity, and he considers it impossible that so 

 little tumor tissue can form so much urinary protein. 



Lindeman believes that, while the Bence Jones protein 

 cannot be put in any group of proteins, it is nearest in struc- 

 ture to the true albumins. Abderhalden states that, judging 

 from the yield of amino acids from the Bence Jones protein, the 

 latter does not correspond to either of the two serum proteins, 

 but may be considered as one of the tissue albumins, which 

 without being broken down or changed into one of the serum 

 albumins, is transmitted to the blood and is then probably 

 eliminated as an albumin foreign to the blood although suited 

 to the needs of the body. 



There is also the possibility that multiple myeloma might 

 be due to a specific bacillus, which by the action of its toxins 

 so alters the normal changes occurring in bone marrow as to 

 form this substance from the tissue protein. 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. Another idea that might be held as to its mode 

 of formation is the following: Possibly the columnar epithe- 

 lium that lines the alimentary canal is diseased, the agent 

 that converts the digestive products may therefore fail to 

 functionate and, in consequence, the incompletely synthesized 

 products are taken into the blood stream and then eliminated 

 as matter foreign to it. This does not seem probable on account 

 of the fact that in cholera, when marked changes are present 

 in the columnar epithelium, the Bence Jones protein is not 

 excreted, although, of course, in cholera the said changes 

 may be insufficient in kind or degree to produce the 

 result. 



