418 THE CHEMISTRY OF TUMORS 



thyroid itself. Adrenal cancers do not usually cause Addison's 

 disease, because they functionate in place of the destroyed gland 

 (Lubarsch). But in the peculiar and characteristic production 

 of cachexia, often apparently out of all proportion to the 

 amount of tumor tissue, there would seem to be evidence that 

 a peculiar and abnormal product of metabolism is formed by 

 cancer-cells. As yet, however, it has been impossible to 

 demonstrate any characteristic toxic substance in cancers. 1 



Because of the constant disintegration of the tumor tissues, 

 products of autolysis are formed, and undoubtedly enter the 

 circulation in small quantities ; possibly they are a factor in the 

 systemic manifestations of malignant growths, but it is highly 

 doubtful whether they are sufficient, either in toxicity or quan- 

 tity, to account for all the systemic effects. 



Since all normal tissue-cells produce substances through 

 their metabolism that enter the circulation, it is quite certain 

 that tumor-cells do likewise, and it is highly probable that the 

 presence of abnormal quantities of such products, even if they 

 are of quite normal composition, may cause disturbances in the 

 body. As yet, however, no such substances, either normal or 

 abnormal, have been isolated, nor has their presence been 

 demonstrated. Numerous isolated observations of ptomai'ns or 

 similar substances in the urine of cancer patients may be found 

 in the literature, 2 but their importance is extremely question- 

 able. 



Hemolytic Substances. A number of observers have de- 

 scribed the finding of hemolytic substances in cancer extracts. 

 Bard 3 observed that in hemorrhagic carcinomatous exudates in 

 serous cavities the blood is rapidly hemolyzed, which is not the 

 case in exudates from other causes. Kullmann 4 found that 

 extracts of carcinomas contain hemolytic substances acting 

 energetically both in the body and in vitro ; these are soluble 

 in alcohol and in water, are not complex in composition, are 

 not specific for human corpuscles, but are toxic for all varieties 

 of corpuscles. Micheli and Donati 5 likewise found hemolytic 

 substances in 8 of 15 tumors, of which 5 acted on all varieties 

 of corpuscles, and 3 acted on only certain varieties ; they regard 

 the hemolytic substances as the products of autolysis in the 

 tumors. It is well known that among the products of autolysis 

 of normal tissues are hemolytic substances. Whether the severe 



1 See Blumenthal, Festschr. f. Salkowski, Berlin, 1904. 



2 See Kullmann, Zeit. klin. Med., 1904 (53), 293. 



3 La Semaine Med., 1901 (21), 201. 

 * Loc. tit. 



5 Kiforma Med., 1903 (19), 1037. 



