METABOLISM IN CANCER 419 



anemia frequently present in carcinoma is due, either largely or 

 in part, to these products of autolysis is unknown, but it is very 

 probable that they have some effect. 



(6) Metabolism in Cancer. Speaking against any 

 specific nature in the cause of cancer cachexia are numerous 

 observations, indicating that the cachexia is in no way different 

 from the cachexia of other conditions. The behavior of the 

 nitrogen metabolism seems to be quite the same as in tubercu- 

 losis and other wasting diseases. There is the same excessive 

 elimination of aromatic substances (phenol, indican) and oxy- 

 acids ('Lewin, 1 Blumenthal 2 ), which Lewin considers to arise 

 from the abnormal metabolism of proteids, and not from putre- 

 factive decomposition in the tumor or in the intestines. There 

 is also the same excessive elimination of mineral salts observed 

 in pulmonary tuberculosis, and termed " demineralization " by 

 Robin. 3 



Israel, and also Engelmann, have reported the occurrence of 

 a marked increase in the lowering of the freezing-point of the 

 blood in carcinoma (as low as 0.60 to 0.63, the normal 

 being 0.56), which they attributed to the presence of exces- 

 sive products of proteid decomposition in the blood. Engel, 4 

 however, found no such increased lowering of the freezing- 

 point in his cases, and questions the significance of the results 

 of Israel and Engelmann. 



(7) Immunity against Cancer. Numerous attempts to 

 produce specific anti-bodies for malignant cells have been made 

 by injecting into animals ground-up tumor tissue, or the blood 

 of cancer patients, or normal tissues of the same origin as the 

 cancer. 5 The results have generally been negative, and the most 

 favorable reports have been entirely unconvincing. Many 

 difficulties, as yet but incompletely surmounted (see Chap, ix), 

 lie in the way of securing specific antiserum for particular cells ; 

 the difficulties in the case of malignant growths is even greater, 

 and at the time of writing the possibilities of therapeutic success 

 by this method are not promising. 



Kullmann 6 found that the serum of animals immunized 

 against cancer tissue exhibits strong hemolytic properties. This 



med. Woch., 1905 (31), 218. 



2 Festschr. f. Salkowski, Berlin, 1904. 



'Quoted by Lewin, loc. cit. Clowes et al. (5th Ann. Rep., N. Y. State 

 Dept. of Health, 1903-4) report observing a slight chloride retention in cancer 

 patients, and review the literature of metabolism in cancer. 



* Berl. klin. Woch., 1904 (41), 828. 



5 Literature by Engel, Deut. med. Woch., 1903 (29), 897. 



6 Loc. cit. 



