400 COCA AND OILMAN. 



Friedberger/ on the basis of strong experimental evidence, believes 

 that the injurious effects of the second injection, in the condition of 

 anaphylaxis, are due to the entrance into the sensitized cells of the 

 previously treated animal's body, of its own complement. This entrance 

 of complement follows the union of the antigen, introduced at the second 

 injection, with the specific antibodies which are present in the sensitized 

 cells. 



The mechanism, therefore, of production of the tumor cachexia, ac- 

 cording to the experimental data at our disposal, would be, first, the 

 establishment of a condition of hypersensitiveness to the epithelial sub- 

 stances of carcinomata due to the absorption of these materials in small 

 quantities; secondly, the continual entrance of complement into the 

 sensitized cells as a result of the constant absorption of tumor material. 



According to this conception, the disappearance of the cachexia fol- 

 lowing the injection of large quantities of tumor substance is to be 

 looked upon as corresponding with the condition Icnown as the state of 

 antianaphylaxis. 



The introduction of the large doses of tumor material results in the 

 formation of an excess of antibodies Avhich are then thrown out into 

 the circulation. The absorption of these antibodies by the tumor cells 

 transfers the scene of injurious complement activity from the normal 

 cells to the malignant ones. 



As already implied, the assumption of von Dungern that the im- 

 munity against malignant growths is due to a local reaction of hyper- 

 sensitiveness, does not seem satisfactorily to explain the results obtained 

 by us in the foregoing experiments. These, we believe, may be best 

 explained by assuming the formation of antibodies in excess, their trans- 

 portation to the malignant cells by the serum and the resulting destructive 

 action upon these cells of the patient's own "complement." 



If this is true, the rational treatment of those cases in which large 

 tumor masses have to be left in the body would be the successive injec- 

 tion at intervals of two weeks (at the end of which time the available 

 antibodies will have been used up) of large quantities (5 to 10 grams) 

 of tumor material. The ideal method of preserving the tissues for this 

 purpose is by freezing. 



In only one of the cases of carcinoma in the region of the neck in 

 group IV was the carotid artery ligated, case No. 8326. At autopsy 

 thirty-nine days after operation the carotid in this case was found to 

 be patent. 



Only one case of malignant growth other than carcinoma has come 

 to treatment, a very advanced case of Hodgkin's disease. This case was 

 apparently uninfluenced by treatment. 



'' Ztschr. f. Immvnitdtsf. Orig. (1909) I, 2, 208 Ibid (1909), 3, 581, 692. 



