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Scientific Proceedings (ioo). 



festing a nitrogen retention, and as this retention became more 

 marked, the hyperglycemia and increased diastatic activity kept 

 pace with it. Apparently, then, the hyperglycemia and lowered 

 carbohydrate tolerance, as gauged by the diastatic activity of the 

 blood, must be attributed not specifically to the malignant new- 

 growth but rather to the impairment of renal function. A further 

 evidence of this impairment of kidney function was furnished by 

 the decreased phthalein excretion, and the presence of protein 

 and casts in the urine. Hypertension was noted in only a few 

 instances. 



This renal involvement was found to be associated invariably 

 with general carcinomatosis; in 90 per cent, of carcinoma ta of 

 the bladder, prostate, uterus and rectum and in about 50 per 

 cent, of gastric carcinomata. On the other hand, carcinomata of 

 the breast and epitheliomata produced no such changes. Of the 

 small number of sarcomata coming under our observation, but 

 one, a sarcoma of the kidney, disclosed a renal impairment. In 

 all cases of non-malignant tumors no impairment of kidney func- 

 tion was noted. Further, the removal of the new-growth did not 

 decrease the concentration of the nitrogenous substances in the 

 blood, but in many instances, anesthesia and surgical procedures 

 provoked an acute exacerbation of the condition. The termina- 

 tion of some of our cases was typically uremic. It is worthy of 

 note that the chemical changes described bore no relation to the 

 age of the patients. 



Three cases of carcinoma of the pancreas have been studied 

 by us. In two instances the diagnoses have been confirmed at 

 autopsy. In all three cases, a hyperglycemia and a markedly 

 increased diastatic activity were found, but in one instance only 

 was there evidence of renal involvement. In this particular case 

 there was an extreme asthenia and cachexia. All three cases 

 showed glycosuria. 



