192  Treatment  of  Human  Cancer.         fAm  jour  Pharm. 
'  (       Apnl,  1913. 
jection  of  the  solution,  an  average  of  300  to  400  c.cm.  of  the  solution, 
warmed  to  about  body  temperature,  being  slowly  introduced. 
Usually  six,  sometimes  seven,  injections  were  given  each  week. 
The  injection  is  invariably  followed  by  a  rise  of  temperature, 
which  varies  usually  between  ioo°  and  1020  F.  Within  six  hours 
the  temperature  again  returns  to  the  normal  level.  The  rise  of 
temperature  is  frequently  inaugurated  and  sometimes  followed  by  a 
more  or  less  severe  chill.  By  diminishing  somewhat  the  quantity  of 
fluid  injected,  the  chill  can  frequently  be  avoided.  The  reaction 
becomes  less  after  a  certain  number  of  injections  have  been  given. 
Simultaneously,  with  a  rising  temperature,  the  pulse-rate  is  usually 
increased.  In  certain  patients  who  had  a  tendency  to  irregular  heart 
action  before  the  treatment  was  begun  this  irregularity  may  be 
accentuated  a  few  hours  after  the  injection.  Otherwise,  no  notable 
changes,  so  far,  have  been  observed  after  the  injection. 
On  the  whole,  patients  tolerate  these  injections  very  well,  and 
their  general  condition  (appetite,  strength,  complexion)  improves. 
The  number  of  erythrocytes  does  not  decrease,  but,  on  the  contrary, 
probably  shows  a  definite  increase. 
Effects  on  the  Tumor. — About  two  to  four  hours  after  an  in- 
jection, hyperemia  is  noticeable  in  the  tissue  adjoining  the  tumor. 
If  the  tumor  is  open,  this  hyperemia  is  accompanied  and  followed 
by  an  increased  secretion  from  the  ulcerated  part  of  the  tumor.  The 
hyperemia  recurs  after  each  injection  in  the  beginning  of  the  treat- 
ment, and  then  gradually  diminishes,  the  increase  of  discharge  of 
fluid  usually  ceasing  three  to  four  days  after  the  first  few  injections. 
Accompanying  the  hyperemia  there  is  present  an  increased  sen- 
sitiveness of  the  tumor.  After  about  fifteen  injections  the  increased 
hyperemia  and  sensitiveness  disappear,  and  the  discharge  becomes 
much  less  marked  than  it  was  before  the  beginning  of  the  treatment. 
There  exist,  of  course,  some  quantitative  variations  in  the  appear- 
ance and  duration  of  these  symptoms.  In  the  report  of  the  individual 
cases  some  of  these  variations  will  be  referred  to.  Very  noticeable 
was  the  diminution  in  the  pain  caused  by  the  cancer,  and  there  was 
no  necessity  of  continuing  the  use  of  narcotics.  The  intravenous  in- 
jections caused  a  gradual  necrosis  and  resorption,  or  sloughing,  of 
the  tumor,  which  usually  proceeds  not  very  rapidly  but  continuously. 
In  some  cases  a  gradual  diminution  in  the  degree  of  retrogression  of 
the  tumor  was  noticeable ;  but  so  far  the  retrogression  has  been  con- 
tinuous, and,  at  least,  two  of  our  cases  are  very  near  a  complete  cure. 
