258 DISEASES OF THE BLOOD 



acid. Zalesky and Erben found likewise no considerable increase 

 in the uric acid in lymphatic leukemia, but in myelogenous 

 leukemia the uric acid was much increased ; on the other hand, 

 the amount of elimination of purin bases was reversed in the 

 two forms, and creatin was decreased in both. Lipstein l found 

 no excessive elimination of amino-acids even in myelogenous 

 leukemia. An increase in calcium is quite constantly observed, 

 and attributed to the bone destruction 2 occurring in this disease. 

 Undoubtedly these variations in results depend upon the 

 known fluctuations in the course of the pathological processes 

 of leukemia ; the number of leucocytes, the size of the lymph- 

 atic organs, and the general condition of the patient all vary 

 greatly from time to time, often with remarkable rapidity, and 

 the excretion of products of metabolic activity must vary like- 

 wise. It can hardly be questioned that the enormous increase 

 in the amount of lymphoid tissue in the body and blood must 

 give rise to a greatly increased nuclein catabolism, with con- 

 sequent appearance of its products (uric acid, purin bases, and 

 phosphoric acid) in the urine. This seems to be well demon- 

 strated by the increased elimination of uric acid and purin 

 bases, together with a general increase in the nitrogen output 

 that has been frequently observed following the therapeutic use 

 of x-rays in leukemia, which is attributed to the increased 

 autolysis that x-rays are known to produce. Lipstein 3 also 

 found an excessive elimination of amino-acids in the urine of 

 leukemic patients treated by x-rays. 4 According to Cursch- 

 mann and Gaupp, 5 the blood of leukemic patients who have 

 been exposed to arrays contains a specific leucocytotoxin, 

 which may be produced by a process of autoimmunization 

 against the leucocytic substance set free by the disintegrated 

 leucocytes. Capps and Smith 6 have obtained similar results. 



Char cot's crystals (also called Charcot-Leyden and Charcot- 

 Neumann crystals) represent a peculiar and striking product of nuclear 

 destruction that has frequently been found associated with leukemia. 



1 Loc. cit. inf. 



2 Stejskal and Erben, loc. cit. 



3 Hofmeister's Beitr., 1905 (7), 527. 



* Literature on eflects of z-rays in leukemia, see Arneth, Berl. klin. Woch., 

 1905 (42), 1204; Musser and Edsall, Univ. of Penn. Med. Bull., 1905 (18), 

 174; Kosenberger, Munch, med. Woch., 1906 (53), 209; Williams, Biochem. 

 Jour., 1906 (1), 249; Lossen and Morawitz, Deut. Arch. klin. Med, 1905 (83), 

 288; Koniger, Deut. Arch. klin. Med., 1906 (87), 31. 



5 Munch, med. Woch., 1905 (52), 2409. 



6 Trans. Chicago Path. Soc., 1905 (6), 371 ; see also Klieneberger u. Zoep- 

 pritz, Munch, med. Woch., 1906 (53), No. 18 ; Milchner u. Wolff, Berl. klin. 

 Woch., 1906 (43), No. 23. 



