Establishment of a Strain Speci- Ally Sensitive to Carcinogenic Agents Applied to the Skin, G

EXPERIMENTAL STUDIES; ANIMAL AND PLANT TUMORS Hereditary Factor in Induced Skin Tumours in Mice: Establishment of a Strain Speci- ally Sensitive to Carcinogenic Agents Applied to the Skin, G. M. BONSER. J. Path. & Bact. 46: 581602, 1938. Three strains of mice were bred ‘by brother-to-sister matings from the offspring of mothers who developed tar warts especially early. One strain (IF) developed warts in response to tarring more quickly than the other two and more quickly than other tested mice, which included stock mice, Kreyberg’s “ white label,” Bagg albinos, and Little’s line of black agoutis (CBA). In the IF strain, 40.2 per cent of the mice had warts at or before twelve weeks, contrasted with 13.8 per cent of the stock mice; at sixteen weeks 72.3 per cent of the IF mice and 35.2 per cent of the stock mice had warts. The range of date of wart development was not different in the two groups, there being great individual variation within each strain. Though warts appeared earlier in the IF strain, they took longer to become malignant. Warts in CBA mice developed later than in the IF strain but became malignant very quickly so that the time from the first tar application to the onset of malignancy was about equal in the two; this time was about the same also in Bonser’s other two lines but slightly greater in Bagg albinos and Krey- berg’s “white label” mice. In the IF mice there was no significant difference in the time of appearance of warts in males and females but by the end of the experiment a greater number of warts had become malignant in the females. There was slight delay in the appearance of warts in Bagg albino and ‘‘ white label ” males compared with the females and the warts took longer to become malignant. Spontaneous mammary cancer was not observed in the IF strain. The Bagg albinos, having a high incidence of mammary cancer, were the least sensitive to tar but the lack of sensitivity was not attributed to the antagonistic action of a mammary cancer since none of the mice developed one before the end of the experiment. Late response to tar was shown by both high-cancer and low-cancer strains and there seemed no actual relation between the response to tar and the tendency to spontaneous mammary cancer. Apparently each strain has its own type of response to any one carcinogenic agent. Similar results were obtained with methylcholanthrene and 3 : 4-benzpyrene except that “ white label ” mice seemed particularly sensitive to benzpyrene. A weak carcinogenic agent accentuated the differences between the times of appearance of warts in early and late strains but the rate of development of malignancy was not changed. The spindle-cell form of squamous carcinoma was much commoner with methylcho- Ianthrene or benzpyrene than with tar, especially in CBA mice. Attempts to breed a strain of mice specially resistant to the action of tar on the skin were unsuccessful. The evidence points to the conclusion that the genetic factor in the development of skin cancer cannot be ignored. It is noteworthy, also, that a special sensitivity to the development of benign tumors is not necessarily allied with rapid development of malignancy; delay in the development of benign tumors may be associated with rapid change to malignancy. The detailed results are presented in thirteen tables. L. FOULDS Changer Antecedent to Tumour Formation during the Treatment of Mouse Skin with Carcinogenic Hydrocarbons, J. W. ORR. J. Path. & Bact. 46: 495-515, 1938. Orr examined the effects of 6 carcinogenic hydrocarbons, 10 non-carcinogenic hydrocarbons of related structure, and some unrelated irritants on the skin of mice. The 589 590 ABSTRACTS substances were dissolved in benzene or, preferably, acetone, which alone produced no changes in the skin. Carcinogenic hydrocarbons produced early epilation ; regrowth of hair occurred in a time roughly proportional to the period required for epilation. The rate and degree of the depilatory phenomena with different hydrocarbons stood in the same order as those of carcinogenesis but some non-carcinogenic compounds produced epilation, though to a much less degree. Ulceration was not infrequent but was not an invariable precursor of tumor formation. Progressive thickening of the skin occurred, most rapidly and prominently with potent carcinogenic substances. Loss of elasticity and venous congestion were also observed. The warts which appeared earliest grew slowly and often regressed; malignancy seemed to develop more rapidly in those nodules which appeared late. The rate of growth of warts appafently was not related to the rate of their production by different hydrocarbons. Potent hydrocarbons produced hyperplasia of the epidermis in a week or two but thereafter there was little change in the epidermis until immediately before tumors appeared. Early epithelial hyperplasia was produced also by Substances which are never carcinogenic. The results tended to show that the action of carcinogenic agents was indirect, neoplasia in the epithelial cells being an indirect effect of alteratione in the subjacent tissues. Infiltrations of inflammatory cells which sometimes occurred were probably attributable to coincident infection. The changes considered significant were (1) transformation of colIagen into a fine-fibered non-refractile type, (2) alterations in the texture of the elastic tissue and (3) passive congestion of the subcutis. The changes in the collagen began in about three weeks, in the euperficial part of the dermis, extended later to the whole dermis, and in places encroached on the subcutis, forming small scars. The sites of tumor development were related to these scars in a significantly high proportion of the mice. Gradual loss of elastic fibers in the superficial parts of the dermis began after four or five weeks. Later the elastic tissue remained subnormal in amount in some mice but increased in the majority, the new tissue being different in texture from the normal. The elastic hyperplada was patchy and there were frequent elastic-free gaps in the dermis; tumors often first appeared at the site of these gaps. In Orr’s opinion the venous congestion is passive, the excessive blood is stagnant, and the effective blood supply is reduced. If this opinion be correct, the observations add to the evidence that tumors arii in cells which are suffering from oxy- gen lack. It is possible that the fibrous scars observed in the subcutis interfered with the local circulation. The paper is illustrated by 14 photomicrographs. A bibliography is appended. L. FOULDS Monocytic Leukemia Md Other Neoplastic Diseases Occurring in Mice Following hh@dC Infection Of 1 :2-$0nZpyren8, J. FURTH,0. B. FURTH,AND c.BREEDIS. Am. J. Cancer 34: 169-183, 1938. In a series of 96 vice receiving splenic injections of benzpyrene in lard neoplasms developed as follows: 5 tumors of the spleen, 28 lung tumors, 6 mammary tumors, 3 tumors described as miscellaneous, 19 cases of leukemia (3 lymphoid, 4 myeloid, 9 monocytic, 3 questionable). In a control series of 95 mice there were no tumors of the spleen, 9 of the lung and 2 of the breast; 6 cases of leukemia were seen, of which 5 were of the lymphoid type and 1 questionable. The tumors at the site of injection in the spleen included 3 sarcomas, one of which may possibly have arisen in the overlying abdominal muscles, and 2 tumors consisting of mononuclear cells associated with generaliked monocytic leukemia. Monocytic leukemia, occurring in 9 per cent of the experimental series, has not previously been described in mice, and was not observed in any of the controls, though it has occasionally occurred in uninjected mice of the stocks (Rf) used in these studies. The lung tumors in the experimental series resembled those in the controls, though the incidence was much higher in the former group, 29 per cent as compared to 9 per cent. The pathogenesis of these tumors is unexplained, but inhalation of the carcinogenic agent was excluded. EXPERIMENTAL STUDIES; ANIMAL AND PLANT TUMORS 591

Two cases of neoplastic hemangioma of the liver and spleen occurred in mice that received intrasplenic injection of cancerigenic chemicals. Similar neoplasms are very rare in mice and were not observed among the controls. Photomicrographs and references are included.

Changes in the Livers of Mice after Adddotration of 3 :4 : 5 :bdibenzcarbazole, E. BOYLANDAND E. H. MAWSON. Biochem. J. 32: 1460, 1938. Single intraperitoneal injections into mice of an olive oil solution of 3 : 4 : 5 : 6- dibenzcarbazole but not of 1 : 2 : 5 : 6-dibenzanthracene or of methylcholanthrene, produce an increase in the glutathione content of the liver. This increase, which is maximal in the first twenty days after the injection, is followed by a marked proliferation of bile ducts in a proportion of the animals. The ascorbic acid, fat and cholesterol contents of the liver remain unchanged. [In a previous paper, the senior author and Brues (Proc. Roy. SOC.,ser. B 122: 429, 1937. Abet. in Am. J. Cancer 31: 496, 1937) showed that 3 : 4 : 5 : 6-dibenzcarbazole produces sarcomata when injected subcutaneously into rats.] A. F. WATSON Appwmce of Giant Neuroglinl Forms after Intracerebrd Injection of Benzpyrene, I. BERTRANDAND J. GRUNER.Apparition de formes nevrogliques gkantes aprhs injection intracbrbbrale de benzopyrhne, Compt. rend. SOC.de biol. 128: 637-638, 1938. Crystalline benzpyrene, in a base of lanolin, was injected intracerebrally into rabbits, each receiving 5 to 15 mg. of hydrocarbon in a single dose. There was no trace of tumor in animals examined at intervals of up to one year after the injection. The benzpyrene was encysted and in about half the rabbits there was a macroglial reaction. Enormous glial nuclei, up to ten times the size of astrocyte nuclei, appeared around the cysts but there was no vascular proliferation or fibrous reaction. The giant neuro- glial forms resembled those described in Wilson’s disease and in Westphal’s pseudo- sclerosis. There was thus an analogy between benzpyrene intoxication and the hepato- lenticular syndromes and the structural relationship between bile salts and carcinogenic hydrocarbons was further confirmed. L. FOULDS

A Microbiological Test for Cucinogdc Hydrocarbons, S. GOLDSTEIN. Science 86: 176-177, 1937. Cultures of the bacillus Escherichia communior treated with the carcinogenic hydrocarbons 1 : 2 : 5 : 6-dibenzanthracene and methylcholanthrene showed in the eighth to the ninth hour of growth about 50 per cent more organisms than control cultures containing the non-carcinogenic compound phenanthrene. Synthedr of 2- and &Substituted Derivatives of 20-Methylcholantluene, L. F. FIESEX AND v. DESREUX. J. Am. Chem. SOC.60: 2255, 1938. Descriptive methods. A. F. WATSON Examhation of the Sarcoma-hducing Benzoylamino Quinoline Styyl Compound “Styyl 430” and Related Subotances for Oestrogenic Action, J. A. W. Mc- CLUSIUEAND J. S. F. NIVEN. J. Path. & Bact. 47: 155-157, 1938. The sarcoma-producing compound styryl 430 and three related compounds were administered to oophorectomized mice but no evidence of estrogenic activity was found. L. FOULDS An Experiment Concerning the Carcinogenic Action of o-Amidoazotoluol: Failure to Produce Malignant Tumor in Chickens, W. NAKAHARAAND T. FUJIWARA.Gann 31: 79-83, 1937. An emulsion of seven- to twelve-day-old chick embryo in a 5 per cent solution of o-amidoazotoluol in olive oil was injected intramuscularly in the pectoral region of 10 chickens. This was followed by weekly injections of the chemical in the area of reaction thus produced. The 6 animals which survived were killed after twenty-two months. The localized nodules showed no tendency to malignant transformation, but consisted of 592 ABSTRACTS a central core of necrotic material surrounded by a connective-tissue capsule. Cirrhosis of the liver of varying intensity developed in all animals, but no evidence of hepatoma was observed. Photographs of the pectoral masses and photomicrographs illustrating the liver changes are reproduced. MILTONJ. EISBN

Occurrence of Cancer in Rate Treated with Oestrone, C. S. MCEUEN. Am. J. Cancer M:i&ei95,1938. Rats were treated for long periods with estrone, applied vaginally or subcutaneously, usually in conjunction with some form of irritation. Among the lesions developing were vaginal carcinoma, cancer and precancer of the uterus, breast cancers, lymphosarcorna, and a carcinoma of the colon. Malignant growths were more frequent in the treated animals than in control rats submitted to the same type of irritation but without estrone injections or in rats of the same colony subjected to other procedures, used for breeding, or set aside without treatment. Photomicrographs and references are included.

Tumor Production by Hormones from Phytomonas tumefaciens, G. K. K. LINKAND H. W. WILCOX. Science 86: 126-127, 1937. Extracts of Phytomonas tumefacicns, the incitant of crown-gall, applied to hypo- cotyls of the red kidney bean caused tumors and the formation of adventitious roots. Similar effects were obtained with applications of heteroauxin in lanolin, inoculations of B. tumefaciens, and simple wounding.

Effect of Terrestrial Rays in the Production of Cancer, G. MIBSCHERAND F. SCHAAP. Zur Frage der krebsbegllnstigenden Wirkung der " Erdstrahlen," Schweiz. med. Wchnschr. 17: 1286-1289, 1936. Cancer and Terrestrial bye, E. JENNY AND A. OBHLEB. Krebs und Erdstrahlen, Schweiz. med. Wchnschr. 18: 33-35, 1937. Cancer and Terrestrial Rays, G. MIBSCHBRAND F. SCHAAF.Krebs und Erdstrahlen, Schweiz. med. Wchnschr. 18: 94, 1937. It was reported by Jenny, Oehler and Stauffer (Schweiz. med. Wchnschr. 17: 572, 1936. Abst. in Am. J. Cancer 30: 160, 1937) that the terrestrial rays detected by the divining rod of a dowser favored the development of tar cancer in mice. The number of tumors and their rate of growth were said to be greater in animals exposed to active rays than in those in neutral zones. Miescher and Schaaf, however, found that the rays were without effect in tarring experiments performed at another site designated by a dowser as being in the path of active rays, or in still another series conducted in the same place as those of Jenny and co-workers. The same tar was used on more than 200 mice in each group. In the first series papillomata developed in 6 per cent of the mice in the neutral area and more extensive tumors in 4 per cent, as compared to 8 per cent papillomata and 5 per cent larger tumors in the animals in the active zone. The experiment was terminated after 266 days. In the second series new growths occurred in 36 per cent of the animals of the neutral area, but in only 30 per cent of those under the influence of the rays. More tar was applied and the experiment terminated after 174 days. One half the animals of the first experiment and all in the second received an intramuscular injection of a drop of 10 per cent India ink for purpose of identification. The authors do not believe that this minute amount of carbon could have had a deflecting effect on possible active rays. Jenny and Oehler attempt to minimize the negative results obtained by Miescher and Schaaf. The latter used a glass rod to apply the tar, but it is difficult to see why the brush method of Jenny and Oehler could assure better effects of the rays. It is faintly possible that the India ink inhibited their action. The experiment, although performed in the same building, may have been invalidated by changes in its structure, for which a filtering effect on the rays is surmised. In their final paper Miescher and Schaaf refute the criticism offered by Jenny and Oehler. Preconceived notions on the existence or action of the terrestrial rays are not sufficient to supplant observations which deny their importance. A criticism that EXPERIMENTAL STUDIES ; ANIMAL AND PLANT TUMORS 593 depends upon such tenuous details as the blocking of rays by a tiny amount of India ink or by unimportant constructive changes in the site of experimentation casts doubt on the significance of rays that under other circumstances are endowed with the power to penetrate the solid walls of ordinary buildings to reach the individuals which they are said to affect. MILTONJ. EISEN

Anti-Carcinogenic Action of the Male Hormone, J. FLAKSAND A. BER. Action anti- cancbrighe de I’hormone male, Compt. rend. SOC.de biol. 128: 506509, 1938. The authors applied methylcholanthrene in benzol to the skin of mice three times a week and gave half the mice injections of “ Sterandryl ” (testosterone propionate) starting a week before the first application of methylcholanthrene. In the first experiment, with 118 mice, Sterandryl somewhat delayed but did not prevent the appearance of tumors. In the second experiment the dosage of Sterandryl was increased and the effect was more pronounced, though only 20 mice were used; after 150 days 9 out of 10 control mice had tumors, of which 4 were carcinomas, while only 3 of 9 mice injected with the hormone had very small warts. L. FOULDS

Lability of the Antiblastic Substances of the Brain, J. MAISIN,Y. POURBAIXAND J. CAMERMAN.Au sujet de la labilitb des substances antiblastiques du cerveau Compt. rend. SOC.de biol. 128: 806-809, 1938. The methods previously described (Am. J. Cancer 24: 357, 1935) for the extraction of substances which inhibit the development of experimental skin cancer in mice sometimes yielded inactive preparations due, it was believed, to the lability of the active principle. To overcome this difficulty, fresh pig brains were desiccated rapidly at low temperatures and the dry powder was used for making extracts. These extracts were fed to mice which were receiving applications of benzpyrene to the skin and significantly lowered the incidence of tumors. L. FOULDS

Changes in the Lymph Glands of Tumour-bearing Mice, D. PARSONS.Nature 142: 480, 1938. During the last few years numerous mouse tumors obtained by the action of pure carcinogenic compounds have been collected and examined at the Royal Cancer Hospital in London. Some of these have proved to be transplantable, and one, a spindle-cell sarcoma (Mal. sarcoma l), has had a unique history. Changes in the blood of animals bearing grafts of the tumor have been demonstrated, and occasionally cell-free filtrates have given rise in other mice to sarcomas resembling the parent tumor. In its 122d generation, a cell-free filtrate of the tumor, together with blood from the mouse bearing the grafted generation, was introduced into an irradiated mouse. A sarcoma (Mal. Fil. 6) was produced at the site of inoculation and the present communication concerns this tumor and its descendants. Three important changes have been observed in mice bearing these tumors. (1) In many animals the lymphoid tissue becomes involved in a widespread neoplastic change affecting the nodes of the axillae, groin, lumbar and mesenteric regions, the degree of involvement showing no relation to the proximity of the grafted neoplasm. Microscopically three types of change have been recognized. (a) Conditions similar to those found in mice after x-radiation or during induction of a sarcoma by a chemical agent may exist. (b) The lymphoid tissue may be more or less wholly replaced by spindle cells similar to those of the tumor grafts. Minute and remote nodes giving no macroscopic evidence of change may be composed of tumor cells. Comparisons of sections suggest that this change begins at the periphery, since the medulla may be entirely surrounded by a band of large, pale cells which extend down the trabeculae in close masses. The condition does not suggest the spread of cells from a metastatic focus but seems more compatible with some further development of process a. The simultaneous changes in nodes on both sides of the body are difficult to explain by any process of metastasis. (c) The normal lymphoid cells may appear to undergo hyperplasia with enlargement of the nodes, suggesting a lymphosarcomatous change, difficult to explain. In some animals, however, the nodes show very little if any microscopic change. 594 ABSTRACTS

(2) Subcutaneous injections of blood from the tumor-bearing mice produce transplantable sarcomas. (3) Portions of lymph nodes, or whole nodes, from mice bearing grafted tumors, when transplanted into mice, induce tumors at the site of inoculation. These can be propagated by grafting. The rapidity of the changes involved is remarkable. For instance a lymph node transferred fronf mouse A to mouse B, five days after grafting the sarcoma in A, has been found fifteen days later to have produced a tumor histologically similar to the parent graft in A. Normal mice grafted with normal lymph nodes have not developed tumors. Investigation of these changes in the lymph nodes of the tumor-bearing mice is being continued. A. F. WATSON

Treatment of Experimental Cancer by Rotozoel Endotodncl, G. ROSKINAND K. ROMANOVA.Arch. internat. de mkd. expbr. 13: 379-384, 1938. Continuing their earlier investigations (Ztschr. f. Krebsforsch. 44: 375, 1936. Abet. in Am. J. Cancer 29: 747, 1937), the authors find that injection of the endotoxins obtained by heating Schizotrypanum crusi for twenty minutes at 4Oo-5O0 C. caused disappearance or inhibition of the Ehrlich mouse carcinoma in all the 43 mice treated, whereas the tumor grew progressively in 27 controls. Injections were begun concomi- tantly with, or shortly after, tumor inoculation. A somewhat better result could be achieved by increasing the dose, and the preparation was found effective against the Flexner-Jobling rat carcinoma, also, but not against the Kritchevsky-Sinelnikov rat sarcoma. The effect appeared to be due to a specific action on the cancer cell, reinforced, perhaps, by stimulation of the reticulo-endothelial eystem. Action of Colchicine on a Transplanted Malignant Lymphoid Neoplum in Mice of the C3E S-, F. J. LITS, A. KIRSCHBAUMAND L. C. STRONG.Am. J. Cancer 34: 196-213, 1938. Mice of the Strong C3H strain bearing a transplanted malignant lymphoid tumor were given subcutaneous injections of colchicine at some distance from the growth. In 14 animals receiving 1/40 mg. of the drug dissolved in 0.1 C.C. of distilled water every three days until they died or were killed, temporary regression of the tumor occurred and the average survival period was 50.5 days as compared with 31.5 days for 13 untreated controls. In no case, however, was there complete suppression of tumor growth. The histologic findings in the tumors at varying intervals following one, two, and three injections are recorded in detail and illustrated by photomicrographs. These studies showed that regression was due to repeated caryoclasic shocks.” Malignant lymphocytes were more susceptible .to the action of colchicine than normal ones. A bibliography is appended. Subrtmcer Controlling the Growth of Implanted Tumoun, W. MOPPETT.M. J. Australia 2: 1065-1069, 1937. Experiments with mice bearing implants of tumor S37 confirmed the conclusions of other investigators that extracts of the anterior pituitary containing both growth and gonadotropic hormones appear to stimulate the growth of implanted tumors, while thyroxin may in certain circumstances have a retarding effect. An attempt was made to isolate the pituitary growth hormone and determine its effect alone, but no reliable results were obtained.

Treatment of the R39 Rat Sucoxna, R. M. BRICKNERAND R. E. GRANT. Science 86: 450, 1937. Femc gluconate having been shown to impede growth of rat sarcoma R39 in one- third of a group of 36 animals, it was decided to precede intravenous injection of that substance by the intraperitoneal injection of neutral red or azo blue on the theory that the dye might make up a chemical bed in the tumor, by virtue of which the iron compound might either be held there in increased quantity or made more effective. Sixty- EXPERIMENTAL STUDIES; ANIMfi AND PLANT TUMORS 595 four animals were so treated and in 47 growth of the tumor ceased after injection of the ferric gluconate. In about half of these regression occurred, but in only a few instances was this complete. Evidently, as indicated by histological study, most of the tumor cells were killed, but a few, especially around the large blood vessels, remained alive and grew again. Microscopic sections showed profound and widespread changes in the tumors, with only occasional normal looking nests of cells.

Ligation of the Splenic Hilus and partial Resection of a Transplantable Mourre Car- cinoma, Y. NAGUMO. Milzhilusunterbindung und partielle Resektion des Tumors beim transplantablen Mauskarzinom, Gann 31: 64-78, 1937. The influence of ligation 6f the hilus of the spleen on the growth and recurrence of the Bashford mouse carcinoma was studied in 5 groups of white mice. The ligation was performed three weeks, two weeks, or one week prior to, at the time of, or two weeks following tumor transplantation. After two weeks of development the tumors were resected, with the exception of a residual portion the size of a rice kernel, which was permitted to remain in situ. The percentage of primary takes did not vary in the operated animals and controls beyond a slight difference in the first group. Here 92 per cent of 147 control mice had tumors compared to 81 per cent of the 176 experimental animals. Following removal of the tumor there was resorption of the non-resected fragment in 50 (37.9 per cent) of 132 animals in which the spleen had been ligated three weeks prior to transplantation, but in only 17 (14.9 per cent) of 114 controls, and in 40 (40.8 per cent) of 98 mice with ligation two weeks before transplantation compared with 22 (20.8 per cent) of 106 controls for this group. The size of the recurrences and the length of life of the positive animals did not vary in the treated as compared to the non- treated animals. The ligation at other periods mentioned had no effect on the percentage of tumor recurrence. The supposition is that so-called autogenous necrohormones arise in the disintegrat- ing spleen after ligation of the hilus, and that these in turn stimulate the activity of other portions of the reticulo-endothelial system. An increase in the general immunity to tumors is the result. MILTONJ. EISEN

Influence of Grafted Tumors on the Action of Folliculin in Mice, J. FLAKS,A. BER AND R. PAKSZWER.Influence des tumeurs greffbes sur I’action de la folliculine chez lee souris, Compt. rend. SOC.de biol. 128: 775-777, 1938. It was previously found that gonadotropic hormone produced no reaction in the vagina or ovaries of mice bearing large transplanted tumors (Flaks and Ber: Bull. de l’Assoc. franc. p. I’btude du cancer 27: 193, 239, 1938. Abst. in Am. j. Cancer 34: 455, 1938). It is now reported that injections of folliculin produced estrus in castrated and immature mice bearing large transplanted tumors and it is concluded that the tumors interfere with the production of folliculin by the ovaries but do not affect the reactivity of the vaginal mucosa. L. FOULDS

Doer &piration Biopsy of Tumors Cause Distant Metastade? J. MCLEANAND K. SUGIURA.J. Lab. & Clin. Med. 22: 1254-1257, 1937. Aspiration biopsy performed repeatedly on transplanted rat carcinoma and mouse sarcoma did not increase the percentage of distant metastases; nor did it produce any demonstrable damage to the tumor capsule or result in implantation of tumor along the needle tract. Trantndtwion of the Rous Filterable Agent to Chemically Induced Tumoun, E. MEL- LANBY. J. Path. & Bact. 46: 447-460, 1938. Tumors induced in fowls by dibenzanthracene or tar were distinguishable, histologically, from Rous sarcoma I and were not transmissible by cell-free filtrates. Cel- lular grafts were inoculated into the breasts of fowls and, when the tumors were established, grafts of Rous sarcoma I were inoculated into the legs of the same birds. The induced tumors were removed eleven to eighteen days later and cellular grafts and cell-free filtrates were inoculated into normal fowls. The filtrates often produced 596 ABSTRACTS, tumors, and these were invariably typical Rous sarcomata, while the grafts always produced typical induced tumors. The Rous agent, though present in sufficient amount to produce Rous tumors, did not, therefore, alter the induced tumor. The actual amount of agent retained in an induced tumor seemed small compared with that in a Rous sarcoma, for filtrates produced tumors less frequently and after a longer delay; it seemed that the agent was attenuated and that its power to multiply in its new habitat was limited. Rous agent was demonstrated only twice in the second transplanted generation of induced tumors which had grown in the same fowl as a Rous sarcoma and never in subsequent generations. Transmission to the second generation, however, was perhaps more frequent than the direct experimental evidence indicated. On two occasions, transplants of the second generation grew well but subsequently regressed and were then replaced by typical Rous sarcomata. It appeared, therefore that, although there might be insufficient Rous agent in the second generation to produce tumors on direct inoculation, regression of the induced tumor might liberate the agent and concentrate it sufficiently to allow it to transform connective-tissue cells into Rous sarcoma cells, Probably the amount of agent demonstrated in the second generation tumors could be accounted for only by its actual reproduction in the tumors. The experiments show that a chemically induced tumor can be infected by a cancer virus agent but do not, in themselves, support the suggestion that chemically induced tumors in fowls normally contain a filtrable active agent. The author’s experience is that chemically induced tumors and virus tumors are essentially different in their nature and are largely independent of, and unaffected by, each other. L. FOULDS Transmisclion of the Rous Filterable Agent to the Nonnal Tissues of Fowle, E. MEL- LANBY. J. Path. & Bact. 47: 47-64, 1938. Cells or cell-free filtrates of organs free from visible secondary growths removed from fowls bearing Rous sarcoma I reproduced Rous sarcoma on inoculation into normal fowls. Many organs were infective, the liver and spleen being the most thoroughly investigated. Infectivity of the organs was first observed about the time the sarcoma implant became established (after seven days) and reached a maximum ten to eighteen days after implantation; thereafter it diminished even though metastasis had occurred and the fowl was near death. Apparently a defensive mechanism developed and was powerful after a month, but most fowls died in three weeks, before the defense was fully effective. Desiccates were similarly infective. The spleen was infective twenty-four hours after a single intravenous injection of Rous filtrate, thqugh the blood was washed out of the organ. The experiments were not conclusive, but it seemed that Rous agent, injected intravenously, rapidly entered the cells of the spleen and remained there, un- reduced, for at least five days. Many organs of tumor-bearing fowls thus contained easily demonstrable amounts of Rous agent without being stimulated to the production of Rous tumors. Mellanby does not think that injury is the factor which determines the localization of tumors but suggests that ‘‘ a Rous tumor is liable to arise at any point in the body where the agent reaches a certain concentration in proximity to connective-tissue cells.” L. FOULDS

Relation of Certain Virusee to the Active Agent of the Roue Chicken Sarcoma, J. W. JOBLING AND E. E. SPROUL.Science 85: 270-271, 1937. While the lipid fraction of the Rous chicken sarcoma is capable of reproducing the tumor in a high percentage of inoculated animals, the active agents of two other virus diseases-vaccinia and tobacco mosaic-were found to be absent in lipid extracts but present in the extracted residue. The authors believe that it is more logical to consider the agent of chicken sarcoma as a product of abnormal cell metabolism than as a virus. Since it is unlikely that the lipid can reproduce itself, it seems probable that it possesses the ability, when injected into normal animals under proper conditions, to stimulate normal cells to produce a similar substance and thus perpetuate the disease. Certainly failure to produce disease with the lipid extracts of the two other viruses examined indicates that they are of a different chemical nature. EXPERIMENTAL STUDIES; ANIMAL AND PLANT TUMORS 597

[Pollard and Amies (Brit. J. Exper. Path. 18: 198, 1937. Abst. in Am. J. Cancer 32: 464, 1938), attribute the production of tumors by lipoid extracts of Rous sarcoma to contamination by traces of the tumor desiccate. Extracts freed of particulate matter by filtration failed to produce tumors in their experiments.] Prepamtion of an Active Agent from Inactive Tumor Extractss A. CLAUDE. Science 85 : 29k295, 1937. Properties of the Causative Agent of a Chicken Tumor, A. CLAUDE. J. Exper. Med. 66: 5P-72, 1937. Filtrates of chicken tumor 10, a slow-growing fibrosarcoma, failed to transmit the tumor except in an occasional instance, but a washed sediment obtained by high-speed centrifugation of the inactive filtrate produced tumors in 50 per cent of the areas injected. Dilutions of the active sediment in the supernatant fluid were inactive, though equal dilutions in water gave positive results, thus indicating that the failure of the untreated filtrate to produce tumors is due not to an inadequate concentration of the agent but to an inhibitory effect of its own supernatant fluid. Similar results were obtained with extracts of the tumor desiccate.

Attempts at Cultivation of Viruses Producing Leukosis in Fowls, J. FURTHAND C. BRBEDIS. Arch. Path. 24: 281-302, 1937. Attempts were made to cultivate leukosis-producing virubes. Four viruses were studied: Virus 1, which produces erythroleukosis and myeloblastic leukemia; Virus 2, which produces lymphomatosis, myelocytomatosis, and endothelioma; Virus 12, a derivative of Virus 2, producing the same type of leukosis, as well as osteochondrosarcoma; Virus 13, which produces sarcoma in the breast muscle into which it is injected, endothelioma of the blood-forming organs, and erythroleukosis. The experiments are fully described and illustrated by photomicrographs. The results are summarized as follows: I' Leukemic myeloblasts of chickens (virus 1) remain viable in witro in liquid cultures for at least thirty days and produce leukosis when inoculated into chickens. " In solid cultures of spleen and bone marrow from chickens with myeloid leukemia a symbiotic growth of myeloblasts and fibroblast-like cells occurs. These cultures likewise have the ability to produce leukosis. "Fibroblast-like cultures of bone marrow of a chicken with erythroleukosis, not containing leukotic blood cells, failed to produce leukosis. Id The leukotic virus 2 survives in uitro for at least thirty-six days in the presence of cells resembling neoplastic endothelium produced in uiuo by this virus. " Osteochondrosarcoma produced by virus 12 when grown in vitro yields fibroblast-like cells. Inoculation of these cells into chickens after ninety-one days of cultivation produced both osteochondrosarcoma and leukosis. . . . I' Cultures of sarcoma produced by virus 13, grown in w'tro for one hundred and fifty-eight days and free from blood cells, produced both sarcoma and leukosis. This observation supports the view that virus 13 stimulates both primitive blood cells and mesenchymal cells other than blood cells. Virus 13 perishes in vitro within approximately two weeks in the presence of normal fibroblastic cells of spleen and of embryonal leg. '' Virus 1, which produces leukosis, perishes in the presence of sarcoma cells produced by a virus that does not stimulate primitive blood cells. These experiments support the opinion that oncogenic viruses multiply in uitro only in the presence of cells on which they confer neoplastic properties. They indicate that a single virus may stimulate both primitive blood cells and fibroblast-like cells. I' The different viruses studied retained their characteristics during a period of observation of from three to five years." Observations on the Shope Rabbit Papilloma, P. LADBWIG. Ueber das Shopesche Cottontail-Rabbit-Papilloma, Schweiz. med. Wchnschr. 18: 165-168, 1937. This paper contains a description of several experiments on the growth of the Shope papilloma in domestic rabbits. Cottontail virus was inoculated into the skin of the 598 ABSTRACTS abdomen and a daily biopsy made to determine the changes that precede the appearance of warts. Specific lesions were evident on the fifth or sixth day. These consisted in swelling of the protoplasm in the cells of the middle and outer layer of the epidermis and the formation therein of a circumscribed group of larger pale cells. This may be called the primary focus. Towards the external surface the cells tend to become smaller and somewhat irregular. Perinuclear vacuoles and an increase in the deposit of kerato- hyaline granules appeared in the cells of the affected area. The findings possibly indicate the site of localization of the virus. Mitotic figures were numerous. On the seventh or eighth day the focus contained fifteen to eighteen layers of cells, and this interval corresponded with the macroscopic perception of a wart. Coalescence of the multiple primary lesions occurred on the twelfth or thirteenth day. Rapid cornification of the superficial layers followed, and there was increased growth of hair in the region of the tumor. Reversible dark pigmentation and depigmentation were frequent not only in the papilloma but also in the involved skin during the early stages of proliferation. A localized encapsulated papilloma was obtained after intramuscular autotrans- plantation of a skin growth. Malignant change in such transplants did not occur. Extensive muscle necrosis was observed about the inoculated material when the primary foci had not as yet developed in the skin fragment, but this phenomenon was absent when tissue containing specific lesions was employed. Autotransplants of papillomatous tissue grew well in the anterior chamber of the eye, and in several instances homotrans- plants in this location were successful. Homotransplantation in other tissues failed. Spontaneous malignant degeneration of a papilloma was noted once, but the time is not stated. In another animal a papilloma reappeared several weeks after complete regression, although no further treatment was used. Small warts developed after inoculation of the virus in the ears, but a latent period of several months intervened before active proliferation took place. Photographs of the warts and photomicrographs are included. MILTONJ. EXSEN Filtmble Agent of the mope Rabbit hpilloma. I. The Influence of Roentgen Rap, P. LADEWIG.Beitrage zur Kenntnis des Shopeschen Cottontail-Kaninchen-Papil- loms und seines filtrierbaren '' Erregers." I. Das Verhalten des filtrierbaren " Erregers " gegen Rthtgenstrahlen, Virchow's Arch. f. path. Anat. 298: 636-640, 1937. Virus fluid of cottontail origin was exposed to varying doses of radiation. Some loss of virulence occurred after exposure to 1,OOO r; the loss was more pronounced after 3,000 r, but the decrease became progressively smaller following 6,000 r and 8,000 r, and was least after 12,000 r. It fell again abruptly to approximately .the 3,000 r level followingexposure to 20,000 r. The irregular effect may be explained by the assumption either of the presence of two antagonistic factors in active virus fluid affected differently by different doses of x-rays, or by the formation of an antagonistic or inhibiting factor during the course of irradiation. It would appear to be more than simple injury of the virus by the direct effect of radiation, especially since it is generally admitted that larger doses are required in order to damage the infectious agents. MILTONJ. EISEN

Fibroma b Infection in Tured Rabbits, C. G. AHLSTROM AND C. H. ANDREWES. J. Path. & Bact. 47: 65-86, 1938. Lesions produced by intracutaneous or subcutaneous injection of Shope fibroma virus persisted much longer in rabbits which had received an intramuscular injection of tar five days previously than in normal rabbits. The fibromas in tarred rabbits resembled neoplasms more closely than'did ordinary fibromas; they were more cellular and free from inflammatory cells, while the cell-inclusions (see following abstract) were larger and more numerous and changes in the overlying skin were almost always present. Clinically and histologically the fibromas in tarred domestic rabbits resembled those in wild cottontails. Subcutaneous tumors sometimes grew progressively in tarred rabbits until death and became fixed to the skin and deep tissues; these tumors closely resembled neoplasms, especially in the appearance of infiltrating, invaaive growth at the periphery. EXPERIMENTAL STUDIES; ANIMAL AND PLANT TUMORS 599

In normal rabbits intravenous injections of fibroma virus produced only small lesions at the site of inoculation and occasionally a few transient skin “ pocks,” but in tarred rabbits fibromas grew at the site of inoculation and at the site of the tar and, in addition, there was a generalized fibromatosis. In some tarred rabbits the various fibroma nodules grew progressively until death, while in others they regressed completely. Histo- logically the fibromas resembled those in other tarred rabbits and invasive growth was sometimes conspicuous. Virus was recovered from fibromas in tarred rabbits at a late stage and was un- modified. Tarred rabbits developed antibodies and became immune to reinoculation in the same way as controls. A single dose of tar on the same day as the virus injection was sufficient to produce the changed reaction. Benzpyrene and other carcinogenic hydrocarbons had similar effects, but it was not proved that the action was specific for carcinogenic substances. Pure benzpyrene was less active than a dose of tar which, presumably, contained much less benzpyrene; tar therefore contained some active sub- etance other than benzpyrene or the action of benzpyrene was favored by some property of the tar. Tar had no effect on infections with the inflammatory strain of fibroma virus nor with vaccinia. Tar had a generalized action exerted, apparently, not upon the antiviral immunity but on the proliferative response. It seems that normal regression of fibromas is not due to antibodies and that some intracellular mechanism for the restraint of a parasitic virus is damaged by tar. Tar enhanced the resemblance of fibromas to neoplasms but it was difficult to decide how far progressive tumors grew aus sich heraus. Though virus was present, growth continued when the rabbits were immune, by ordinary tests, to reinfection, so that probably growth was due to the multiplication of already infected cells. There are 10 photomicrographs and a bibliography. L. FOULDS

A Tnnrplrnhble Sarcoma Occurring in a Rabbit Inoculated with Tu and Infectious Fibroma Yirus, C. H. ANDREWESAND C. G. AHLSTR~M.J. Path. & Bact. 47: 87-99, 1938. As previously reported (Andrewes et al: Lancet 2: 893, 1937. Abst. in Am. J. Cancer 32: 138, 1938), a rabbit which had received two intramuscular injections of tar, four and one-half months apart, and then an intravenous injection of Shope fibroma virus, developed a tumor at the site of the tar. The tumor (designated RS I) has now been transplanted in series through twelve generations. At first, transplantation was required after ten to sixteen days’ growth, since all the tumors eventually regressed, but later many grew progressively and sometimes metastasized. The later tumors were more cellular and less fibrous and contained many cells in mitosis, but no inclusions of any kind were found in the tumor cells. The RS I tumor was a true sarcoma though a relatively benign one. It was not transmissible by cell-free preparations and all attempts to demonstrate fibroma virus, by direct or indirect methods, failed. It seemed likely that both tar and fibroma virus were concerned in the origin of RS I. Two working hypotheses are suggested: (1) It is possible that when fibroma virus per- dsts in a rabbit for a long time, as in tarred rabbits (see preceding abstract), a mutant virus is produced and the mutant, having a particularly close adaptation to the infected cells, is able to multiply in them and be carried to the daughter cells but is unable to infect new cells. (2) It is possible that the growth energy of the cells altered by tar is insufficient for progressive growth without the added proliferative stimulus of an infection by fibroma virus. Both hypotheses may need revision. L. FOULDS

~tOlOqgof the Infectious Fibroma in Rabbits, C. G. AHLSTR~M.J. Path. & Bact. 46: 461-472, 1938. The progress of the lesions produced by fibroma virus (usually the OA strain producing chiefly a proliferative reaction) was studied in domestic rabbits. The earliest histologic change after intracutaneous inoculation was edematous loosening of the subepithelial tissues with infiltration of inflammatory cells. Fusiform or stellate fibroma cells appeared in the edematous tissue, especially around newly formed capillaries. The fibroma cells originated from perivascular histiocytes and endothelial cells as well as 600 ABSTRACTS from fibroblasts. The histologic appearances, together with the results of experiments in which local blockage with india ink or trypan blue delayed the reaction to virus, indicated that the action of the latter was directed against the undifferentiated mesen- chyme in its widest sense. The early stages were granuloma-like. There were often extensive edematous infiltration and abundant inflammatory cells within and around the tumor. There was frequently an evident resemblance to myxomatosis. In later stages, neoplastic features dominated. Inflammatory cells were then mainly restricted to the periphery and the tumors consisted of fibroma cells. After about a week, the fibroma cells contained basophilic cytoplasmic inclusions which increased in size and number until just before regression began. Most probably the inclusions represented degeneration products and indicated that the virus caused degeneration as well as proliferation of cells. Some fibroma cells contained small acidophilic granules of uncertain nature. There was sometimes hyperplasia of the overlying skin epithelium and enlarged cells contained eosinophilic granules; similar but more pronounced reactions to fibroma lesions occur in cottontail rabbits. Regression of fibromas occurred through a combination of necrosis and resorption. There are 9 photomicrographs and a bibliography. L. FOULDS Experimental Studies on the Pathogenesis of Xanthoma: Lipid MetaboUem and Development of Xanthoma in the Rabbit Following Administration of Lanolin, F. SCHAAF. Experimentelle Beitrage zur Pathogenese der Xanthoma (Xanthom- entstehung und Lipidstoffwechsel beim Kaninchen nach LanolinfUtterung), Arch. f. Dermat. u. Syph. 175: 279-333, 1937. Cholesterol, cholesterol esters, and phosphatides, in conjunction .with the proteins and the salts of fatty acids, are the constituents of serum which produce emulsification of the circulating neutral fats, and this mechanism is probably associated with a regula- tion by the liver of the metabolism of the emulsifiers first mentioned. Abnormalities in this system (changes in the cholesterol-cholesterol ester ratio, or in the amount of the phosphatides) disturb the emulsifying process. When such a condition develops sufficiently, the poorly emulsified fat globules tend to become deposited in the tissues. Local changes, as mechanical trauma or inflammation, may act as predisposing factors to deposition in the case of a partial disturbance of the normal emulsion. The pathological process may in addition be favored by an alteration in the chemical composition of the tissue fats. With this hypothesis as a possible basis for the spontaneous development of xanthoma in man, the author attempted in a number of prolonged experiments to reproduce xanthomatous lesions in 9 adult rabbits. A drastic method of combined treatments which varied considerably in different animals led to the production of distinctive skin changes in 8 rabbits; nevertheless, spontaneous xanthoma as observed clinically is certainly not associated with the extreme and artificial circumstances of the experiment. An increase in the total blood fat and quantitative changes in the various fractions were produced by daily feedings of 5 grams of lanolin mixed with oatmeal. For attaining the desired effect, this complex fat containing a large percentage of free and esterified cholesterol proved more advantageous than egg yolk. Liver damage was produced in 7 animals by intravenous injections of salvarsan or irradiation of the exposed organ approximately one year prior to other treatment, or by the administration of toluylene diamine during the entire course of the experiment. A combined method was employed in several rabbits. Repeated intracutaneous injections of different mixtures of neutral fat, cholesterol, and lecithin were given in four sites on the'abdomen to create a change in the fat content of a localized area. No relationship between the composition of the injected fat mixture and the extent of the lesions which followed could be detected. The injections were accompanied by the additional factor of inflammatory reaction. Folds produced by metal clamps attached to the epilated skin of the back were used as a method of observing the effect of deliberate and continuous mechanical injury. This intervention tended to increase the area of the resulting skin lesions. The period of observation lasted for nine to twenty-five months, and the general condition of the animals during this time remained satisfactory. The original paper should be EXPERIMENTAL STUDIES; ANIMAL AND PLANT TUMORS 601 consulted for more extensive details of the experimental methods and the quantitative estimations performed. Definite skin changes developed not only in the injected regions and the areas of mechanical injury but also in many non-treated portions of the abdomen, back, flanks and thighs. The sites of predilection, however, were the back, flanks and in the skin folds (possible effect of physiological injury). After an interval varying from nine to fifteen months doughy, yellow-white infiltrations appeared and these produced a thickening of the skin and subcutis. The condition was not progressive; periods of regression and extension alternated, and signs of secondary inflammation were frequent. The lesions varied from 2 to 3 mm. to several centimeters in diameter and were either diffuse or patchy. Histologically they were uniform and of a simple nature. Fat, containing doubly-refractile components, filled the spaces of the cutis, especially its papillary and deep portions. This primary deposition was followed by a proliferation of reticulo- endothelial cells, and these in turn phagocytosed the lipids to become large foam cells or xanthoma cells. The cells are of the characteristic typaseen in the spontaneous lesions. The proliferation of the phagocytes is believed to precede the fat deposition in the human form, but this difference from the experimental prototype may be an apparent one, since in man the lesions are ordinarily not examined in an early stage. The Fnfluence of the liver injury is difficult to evaluate. Although typical skin changes occurred in the 2 animals where no deliberate attempt was made to damage the organ, the earliest lesions were observed in animals receiving either radiation or toluylene diamine. Eye changes developed in 6 of the 7 animals of this group. These consisted of xanthomatous infiltration in the sclera and ciliary body in 1 rabbit and the formation of an arcus senilis in 5 animals. Complicating the process is the fact that degenerative phenomena occurred in the liver after simple prolonged administration of the high-fat diet. All animals had enormously fatty livers. Further, 1 control animal which received radiation and fat injections in the abdominal skin but a normal diet showed abortive xanthoma formation about the injected area. The purely local reaction to the injections or the mechanical trauma in other controls was easily distinguishable from the more extensive lesions in the animals receiving the fatty diet. Fatty infiltration in the intima of the larger blood vessels was noted frequently in the latter group of rabbits. Examination of the blood fats demonstrated after an interval of one year distinctive and progressive changes in the animals on the high-fat diet. There was an increase in total fat, cholesterin (esterified form), and phosphatides. In some animals this was manifested by.~ grossly perceptible lipemic clouding- of the serum. Importance is attached esterifiedcholesterin to the quotient which in normal animals averages 0.74, and in phosphatide phosphorus the treated 1.53. The abnormal ratio is considered an indication of the disturbance in the quantity of emulsifying agents of the serum. It will be recalled that this change formed the basis of the author's hypothesis implicating a faulty fat metabolism as the cause of xanthoma. Similar quotients are reported in the spontaneous disease in man, despite the absence of a prolonged high-fat diet. Chemical analysis of the skin lesions of the rabbit revealed an increase in the total fat, cholesterol and cholesterol esters, but the phosphatide values were within the limits of the normal. It will be noted that the fat deposits are formed principally of those components ingested in abnormally large quantities. The paper contains photographs of the xanthomatous lesions in the rabbits, photomicrographs, an ample number of tables, and a bibliography. MILTON J. EISEN

Proetatic Hypertrophy, C. F. GESCAICKTER.Am. J. Roentgenol. 38: 389-402, 1937.. Studies of the prostate were carried out in 12 monkeys before and after the injection of prolan, estrone, or testosterone. Non-castrated monkeys receiving high doses of prolan showed a diffuse enlargement of the prostate, but this was not observed following prolonged treatment with moderate doses or in castrated animals. The effect was inhibited by previous irradiation of the prostate, but this is attributed to injury of the testes. 602 ABSTRACTS

When marked enlargement and cystic changes were produced in the prostate they were accompanied by hyperplasia of the interstitial cells of the testicle, by urinary retention, and by dilatation of the bladder. Estrin in moderate doses (25,000 international units over a period of ten days) resulted in an increase of the fibromuscular stroma of the prostate; following doses in excess of 1,500,OOO international units given over a period of a month the size of the prostate was diminished. Testosterone produced no noticeable prostatic enlargement, though it restored the prostatic epithelium in a castrated animal. Its predominant effect was enlargement of the seminal vesicles. Photomicrographs are included and there is a bibliography.

Isotopic Conatitution d Potuaium in Nodand Tumour Tiruue, A. LASNITZKIAND A. K. BREWER. Nature 142: 538, 1938. The authors have studied the isotopic constitution of potassium present in normal and tumor (Jensen sarcoma) tissue of the rat. The abundance ratio tIKflAK and thereby, practically, the concentration of the heavy isotope tiK was estimated in potassium present in the ashes of the tissues, the measurements being carried out by means of a maw spectrograph described by one of the authors (Brewer: J. Am. Chem..Soc. 58: 365, 1936; 59: 869, 1937). Ashes for the estimations were obtained from mixed normal tissues taken from an equal number of males and females of 21&225 gm. weight, and from two groups of tumor animals: (a) rats of the same average weight as above, eighteen days after the inoculation of the tumors, and (b) animals of much lower average weight, fourteen days after inoculation. The content of tiK in potassium present in red blood corpuscles as well as spleen, lymph nodes, and heart muscle was similar to that in mineral potaseium contained in ordinary potassium chloride. By contrast, that present in bone, including marrow, showed an increase of about 1.7 per cent, and that of sarcoma tissue, a decrease of 1.0- 1.3 per cent. Both living and necrotic portions of tumor were used in the preparation of the samples but other samples prepared from living parts showed the same percentage. [The inclusion of data from ashed tumor and non-tumor tissues of rats of the same batch would have been of interest.] A. F. WATSON Incidence of Spontaneous Tumon on a ‘‘ Mixed Oatmeal Diet,” L. C. STRONG.Gann 31: 13-16, 1937. Spontaneous tumors developed in 6 (4.8 per cent) of 124 female mice of the CBA strain on a mixed oatmeal diet. Four animals had cancer of the breast and two hepatoma. The incidence in a previous series was 5.6 per cent. MILTONJ. EISEN

Hereditary Facton Prediapodug b M.mmrrrr Cancer in Mice, R. KORTEWEG. De erfelijke factoren, welke de dispositie voor tanker van de borstklier bij de muis befalen, Nederl. tijdschr. v. Geneesk. 80: 4008-4014, 1936. Also in Genetica 18: 350-371, 1936. Crow-breeding experiments were carried out using the Little strains of mice-the black, which shows almost no spontaneous mammary cancer, and the dilute brown strain, which has a high incidence. It was concluded that the predisposition to cancer is determined not only by a chromosomal factor but also by an extrachromosomal factor, present probably in the cytoplasm of the ovum. [Murray and Little, using these same strains, reached a similar conclusion (Am. J. Cancer 27: 516, 1936).] EDWARDHERBERT, JR.

Adenomatour Leaion in Stomach of Stnin I Mice, H. B. ANDERVONTAND H. L. STEW- ART. Science 86: 566-567, 1937. Andervont and Stewart describe the spontaneous occurrence of an adenomatous lesion in the stomachs of mice of the I strain, which not only shows no spontaneous mammary carcinoma but has proved resistant, also, to transplantable sarcomas 37 and EXPERIMENTAL STUDIES; ANIMAL AND PLANT TUMORS 603

180 and to the induction of subcutaneous tumors by lard solutions of the carcinogenic hydrocarbons.

A Sex-DiUerence in the Incidence of Bone Tumoure in Mice, F. C. PYBUSAND E. W. MILLER. Am. J. Cancer 34: 248-251, 1938. In an inbred strain of mice with a high incidence of spontaneous bone tumors, it was found that these tumors are more than 2.5 times as frequent in the females as in the males (77.3 per cent compared with 29.6 per cent) and occur nearly two and a half months earlier.

Mdtiph ~eOpbIU6in 8 SarCOIlW Of Mice, F. c. PYBUS AND E. w. MILLER. 34: 252-254, 1938. Among 195 mice of the Simpson strain 134 had tumors. Multiple neoplasms occurred in 29.4 per cent of all the tumor bearing mice, and in 36 per cent of the females and 34.5 per cent of the males with bone tumors. In only 14.1 per cent of the females was no trace of neoplasm found, bul 50 per cent of the males were without tumors, a difference which is due entirely to the higher incidence of bone tumors in females of the sarcoma strain (see preceding abstract).

Histopathology of Tumors of the Interstitial Gland of the Testis in Man and Animals, A. PBYRON,L. BLANCHARD,G. POUMEAU-DELILLEAND L. SALOMON.Sur 1’- histopathologie des tumeurs de la glande interstitielle du testicule chez d’homme et lee animaux, Compt. rend. Soc. de biol. 128: 338-340, 1938. Varying degrees of neoplasia were observed in the interstitial tissue of the testis in 50 out of 400 dogs, most of which were old. Three stages were distinguished. Stage I, found in 22 dogs, consisted of simple hyperplasia, the structure being identical with that of normal interstitial tissue. Stage 11, seen in 14 dogs, was characterized by adenomatous nodules. In Stage 111, present in 15 dogs, there were tumors in active growth, some of them in course of malignant transformation. Interstitial neoplasia was much rarer in horses; one hyperplastic nodule and one benign tumor were found in 275 old horses. Histologic examination supported the view that the interstitial tissue is epithelial and of endocrine nature. The structure of the tumors in dogs corresponded with that of certain human tumors which cause precocious puberty and since the seminiferous tissue was normal or even atrophied the hormone action producing abnormal growth must be attributed to the interstitial tissue alone. L. FOULDS

R~E~XIC~of Reinke’r Crpstrlloide fn the Hyperphias and Tumorrr of the Interstitirl Gland of the Tertla, A. PEYRON,G. POUMEAU-DELILLEAND L. SALOMON.Sur la prknce des crystalloides de Reinke dans les hyperplaties et tumeurs de la glande interstitielle du testicule, Compt. rend. SOC.de biol. 128: 649-651, 1938. The crystalloids of Reinke, though well known in man, have not been reported previously in the interstitial tissue of the testes in domestic mammals. The authors identified them in the hyperplasias and tumors of the interstitial tissue which are common in old dogs (we preceding abstract). L. FOULDS

LeuLemic Lymphoblastoma in a Calf: A Hematologic and Hietologic Study, J. STASNEY AND W. H. FELDMAN.Am. J. Cancer 34: 240-247, 1938. A calf with leukemic lymphoblastoma was observed for three weeks before death, during which time repeated observations of the peripheral blood and cytologic studiea were made and several lymph nodes were removed at intervals for biopsy. The histopathologic picture of the peripheral blood and of the different organs obtained at necropsy was similar to that of lymphatic leukemia in human beings. In some of the enlarged lymph nodes the histopathologic changes were aimilar to those of lymphosarcoma. Fundamentally these changes were those of a neoplastic process in which invasion of the blood had occurred secondarily. Photomicrographs are included and there are several references. 604 ABSTRACTS

Rogremlve Growth Stages of a Heritable Melanotic Neoplastic Disease in Fishes from the Day of Birth, M. GORDONAND G. M. SMITH.Am. J. Cancer 34: 255-272, 1938. Continuing work on melanotic neoplastic disease in hybrid fish (see Am. J. Cancer 19: 732, 1495, 1931; 30: 362, 1937) begun by Gordon and Reed, the present authors have studied the progressive stages from the day of birth. These are as follows: (a) a macromelanophore hyperplasia in the corium of the integument; (b) a macromelanophore invasion of the intermuscular tissues along the muscle septa; (c) a smaller, spindle- shaped, pigment cell hyperplasia in the corium and in the intermuscular tissues. The spindle cells of the melanotic overgrowths in hybrid fishes histologically resemble the cells of mammalian melanosarcoma. They also are infiltrative and destructive to adjacent tissue. Metastases have not been observed. Photomicrographs and drawings illustrate the paper and references are appended. Effect of Certain Enzymes and Amino-Acids on Crown Gall Tissues, P. A. ARK. Science 85: 364, 1937. Injection of the enzymes diastase, papain, pepsin, cysteine hydrochloride, leucine, and iso-leucine caused regression of crown galls, which dried up under the treatment, leaving only easily removable vestiges. Tryptophane and tyrosine failed to produce similar results. [Regression of Jensen rat sarcoma has been reported following treatment with cysteine hydrochloride (Connor, Carr, and Ginzton: Proc. Soc. Exper. Biol. & Med. 34: 374, 1936. Abst. in Am. J. Cancer 28: 788, 1936).]

THE TUMOR CELL DMerential Diagnosis of the Cancer Cell, G. ROSKIN. Sur le diagnostic cytologique differentiel des cellules cancbeuses. Bull. d'histol. appliq. la physiol. 15: 20-23, 1938. Continuing his investigations with rongalite white, the leucobase of methylene blue (Roskin and Solowjewa: Acta Cancrol. 1: 461, 1935. Abst. in Am. J. Cancer 27: 365, 1936), the author found that malignant tumors from various species of animals resemble one another in failing to take up the stain. This negative reaction, which so far appears to be characteristic of malignancy, and might therefore prove to be of value in diagnosis, suggests some abnormality in cell physiology. WM. H. WOGLOM Effect of G.mmr Radiation on Mitosis, SHIELDSWARREN. Am. J. Roentgenol. 38: 899-902, 1937. The effect of gamma radiation on mitosis was studied in Walker carcinoma 256 in vioo. Animals were killed at intervals after irradiation and counts were made in sections from various parts of the tumors. Radon was found not to differ essentially from roentgen radiation in its effect on mitosis. The premitotic phase was most sensitive to the gamma rays. References are appended. Resieturce of Animal Cells to Cold, J. KLINKB. Zur Kiilteresistenz tierischer Zellen, Naturwissenschaft. 26: 594-595, 1938. The author found that animal cells, whether from normal tissues or from transplantable neoplasms, can be exposed to the temperature of liquid nitrogen (- 196" C.) without necessarily being killed thereby, thus supporting observations recorded long ago by Moore and Walker (Lancet 1: 226, 1908). WM. H. WOGLOM GENERAL LABORATORY AND CLINICAL OBSERVATIONS 605

GENERAL LABORATORY AND CLINICAL OBSERVATIONS; MISCELLANEOUS CASE REPORTS

Physico-chemical Investigations on the Serum of Cancer Patients, R. JONNARD. Investigaciones flsico qulmicas sobre el suer0 de cancerosos, Bol. Inst. de med. exper. para el estud. y trat. d. cincer 14: 141-158, 1937. The author has studied the blood serum of 21 cancer cases in respect to magnetic susceptibility and refraction index and believes that such methods may lead to a closer understanding of serum proteins. The magnetic susceptibility or magnetic induction is determined by the method of Pascal (Compt. rend. Acad. d. sc. 150: 1054, 1910). This consists in hanging a small capillary tube from one arm of a delicate balance between the poles of an electromagnet. When the magnet is excited the attraction of the field can be measured by placing weights on the other scale.

Effect of Colchicine on Human Tumors, A. W. OUGHTERSON,R. TENNANT,JR. AND J. W. HIRSHFELD. Proc. SOC.Exper. Biol. & Med. 36: 661-664, 1937. Fifteen of 21 tumor patients in whom a biopsy had previously been done were given colchicine either subcutaneously or intramuscularly, the dosage varying from 1 to 4 mg. in saline. In most instances a second biopsy was done or the tumor was excised nine and a half hours after administration of the drug. For example, a man of fifty with a carcinoma of the sigmoid colon received 4 mg. of colchicine subcutaneously. Five hours later and again at nine and a half hours biopsies were performed, and at twelve hours the tumor was removed. The successive biopsies showed a constantly increasing number of mitotic figures. In the twelve-hour specimen the increase had reached more than 700 per cent and as many as 50 per cent of the cells were in mitosis. Two photomicrographs are included. A Theory as to the Undetermined Primary Origin of Metastatic Carcinoma, A. FREED. M. Rec. 145: 422-424, 1937. The author suggests that the occasional occurrence of metastatic carcinoma with no trace of a primary growth may be explained by the ameboid property of the embryonic cell, which wanders away from its site of origin to proliferate and form a tumor elsewhere. Three cases are recorded. Traumatic Origin of a Tumor Metastasis? M. RICHARD. Traumatische Entstehung einer Tumormetastase? Schweiz. med. Wchnschr. 18: 649-650, 1937. Following a fall and injury to the hand a painful swelling, approximately 3 cm. in diameter, developed in the medial portion of the extensor surface. The mass trans- mitted arterial pulsations. A roentgenogram four months later showed complete destruction of the unciform bone. A friable mass of tumor tissue excised from this region had the histologic structure of hypernephroma. No primary growth was found. Further details are not given. Since roentgenographic signs of bony change were present as early as twenty days after the injury, it would appear logical to assume that the trauma was an incidental event affecting a part previously involved by neoplastic disease. Roentgenograms are included. There are no illustrations of the microscopic appearance of the tumor. MILTONJ. EISEN

Metastatic Deposit of Bronchial Carcinoma in a Hydrocele Misdiagnosed ti End+ thelioma,” with a Review of Supposed “ Endotheliomas ” of Serous Membranes, R. A. WILLIS. J. Path. & Bact. 47: 35-42, 1938. A large malignant growth in a long-standing hydrocele was removed surgically and diagnosed histologically as endothelioma of the tunica vaginalis. The patient died fifteen months later with a recurrent growth extending into the groin and iliac fossa. Post mortem, a small symptomless carcinoma was found in a bronchus, together with tumor deposits in lymph nodes, peritoneum, and contralateral lung; there was one nodule in the liver. All the growths had the same structure and it was cetain that the bronchial tumor was the source of the hydrocele tumor. There was no trace of lymphatic spread to the hydrocele. Possibly a blood-borne embolus was arrested in one of the areas of 606 ABSTRACTS granulation tissue which may occur in the walls of old hydroceles which have been repeatedly tapped, the hydrocele tumor thus being a striking example of preferential metastasis in an area of diseased tissue. Willis admits the possibility that primary endothelioma of serous membranes can occur, but has not yet found any report in which the diagnosis rests on scientifically adequate grounds. He states that " there are no distinctive histological criteria of endothelioma " applicable to coelomic tumors, and that " the diagnosis of 'endothelioma' cannot be considered unless complete post-mortem examination has excluded, as a possible source of carcinoma, each and every epithelial structure in the body." The misdiagnosis of the hydrocele tumor was corrected at autopsy, but the primary tumor was so inconspicuous that it might have been missed in the course of a fairly thorough examination, had not special search been made. There are ten photographs of gross and microscopic specimens and a bibliography. L. FOULDS Care of Enlarged Abdominal Organs, Cerebral Glh-angio5broma and Early Primary Adenocardaomr of the Common Hepatic Duct, H. IKUTA. Uber einen intereesanten Fall von Splanchnomegalie, mit Kombination von Glioangiofibroma cerebri und beginnendem primlirem Adenokarzinom des Ductus hepaticus communis, Gann 31 : 121-124, 1937. A number of pathological processes coexisted in a man of forty-four in whom illness had been manifested by abdominal pain, icterus, and anasarca. The abdominal organs and heart were enlarged both grossly and microscopically, but the glands of internal secretion were atrophic. Other evidences of developmental abnormality were a urachus cyst in the wall of the bladder and a circumscribed sclerosed glioma, measuring approximately 2 X 1 cm., in the orbital gyrus of the left frontal lobe. The mass contained many small blood channels. Biliary cirrhosis and a stenosing adenocarcinoma of the common hepatic duct with a metastasis in a portal lymph node accounted for the abdominal symptoms. A photograph of the cerebral mass and photomicrographs are reproduced. MILTONJ. EISEN

RhaUm*tic C-er in S~eMcrlHOIM~~~OXM~ of the Feet, L. JEKER. Ein Fall von symmetrisch gelegenem Htimangiom beider FUsse mit rheumatischen Vertinder- ungen, Schweiz. med. Wchnschr. 18: 633-634, 1937. Bilateral hemangiomata, approximately 1 cm. in diameter, were excised from the first interdigital spaces of the foot in a patient of thirty-two years. There was a history of attacks of acute rheumatic fever twenty and six years previously. Fibrinoid connective tisaue changes of characteristic rheumatic type were present in the stroma of the growths. A photomicrograph is included. MILTONJ. EISEN B[remurgeioblartomr of Sacrum, R. J. V. PULVERTAFT.J. Path. & Bact. 47: 101-104, 1938. A girl aged sixteen hurt her back by falling downstairs. A radiological examination immediately afterwards revealed erosions of the bodies of the last lumbar and first two sacral vertebrae: the lesion therefore was not entirely traumatic, as at first supposed, but was the cause of the fall. The patient died twenty months later after suffering fcom double incontinence. At autopsy, a maroon-colored gelatinous lesion was found occupying the position of the last lumbar vertebra; it had destroyed the related inter- vertebral discs and invaded the spinal canal. The growth was apparently malignant and was diagnosed, histologically, as hemangioblastoma. The author found no previously recorded case in which a sacral angioma produced symptoms. L. FOULDS Sa-Wgd Dmdd Cpt nith Imminent Firtul. Fotmrtion, R. DIEULAF~. Kyste dermolde sacro-coccygien en voie de fistulisation, Toulouse med. 37: 316-318, 1936. A man twenty-six years of age had a small tumor removed from the coccygeal region. It was found to be a dermoid cyst which had greatly thinned the overlying skin. The probability of fistula formation is discussed. There are no illustrations. EDWARDHERBERT, JR. DIAGNOSIS AND TREATMENT 607

DIAGNOSIS AND TREATMENT Kleh Cancer Test, A. FEHR. Unsere Erfahrungen mit der Klein'schen Krebsreaktion, Schweiz. med. Wchnschr. 18: 8-10, 1937. The Klein serum test did not prove of value in the diagnosis of cancer. It was positive in only 33 (38 per cent) of 86 patients with cancer, and negative in 26 (63 per cent) of 41 cases of benign tumor and in 118 (80 per cent) of 147 individuals free from neoplastic disease. The large number of factors, such as operative intervention, medication, radiation therapy, bleeding] etc., which admittedly disturb the reliability of this test further detract from its possible usefulness. MILTONJ. EISEN Physico-chemicol Conditions of the Serologic Reaction of Cancer, M. ARON. Condi- tions physico-chimiques de la reaction sbrologique du cancer: rble des concentrations du pH de la temperature, Compt. rend. SOC.de biol. 128: 91-93, 1938. Aron discusees additional technical details of the serologic test for cancer which he has devised (Absts. in Am. J. Cancer 29: 769, 1937; 30: 164, 165, 1937; 31: 511, 1937; 33: 587, 1938). L. FOULDS Degree of Speciacity of the Serologic Reaction for Cancer, M. ARON. Degrb de spki- ficite de la reaction sbrologique du cancer, Compt. rend. SOC.de biol. 128: 93-95, 1938. The serologic reaction described in previous papers (see preceding abstract) gave positive results in all but 4 of 70 patients in whom carcinoma was diagnosed with certainty. To obtain positive results with sarcoma it was necessary to replace the usual urinary extract obtained from carcinoma patients by one from sarcoma patients. Sometimes positive results were obtained in patients with supposedly benign tumors, but no positives were obtained in 120 patients with non-neoplastic diseases. The reaction therefore seems strictly specific. A statistical analysis of the results is in preparation. L. FOULDS

Rble of Polypeptides in Aron's Cancer Test, H. BULLIARDAND I. GRUNDLAND.Rble des polypeptides dans la rkction du cancer de M. Aron, Compt. rend. Soc. de biol. 128: 298-301, 1938. The authors attribute the reactions obtained by Aron with his specific cancer pnn- ciple " X " to polypeptides which are increased in the blood and urine of cancer patients and produce changes in the adrenals. [For references to Aron's reaction see abstracts above.] L. FOULDS Behavior of the Adrenal Lipprotein Complex in Aron's Cancer Test, I. GRUNDLAND AND H. BULLIARD.Le comportement du complexe lipoprotbique surrbnalien dans le rhction du cancer. Comparaison des resultats d'examens histologiques et dosages des graisses de le surrbnale, Compt. rend. SOC.de biol. 128: 302-304, 1938. Polypeptides produce an apparent diminution in the fat content of the adrenals but after prolonged administration cause an apparent increase. These appearances do not correspond with chemical estimations but are due to changes in the cohesion of the lipo-protein complex. These phenomena could be used in the diagnosis of cancer with the reservation that several pathological and physiological conditions accompanied by an increase of polypeptides in the blood might influence the reaction. [See preceding abstracts.] L. FOULDS Biologic Basis of the Fractionated Method of Irradiation of Malignant Tumors, J. BORAK. Radiology 30: 439-450, 1938. This paper which appeared in German in Strahlentherapie is abstracted in the American Journal of Cancer 33: 139, 1938. 608 ABSTRACTS Systematic Analysis of the Blood of Cancer Patients During Radiotherapeutic Treat- ment, F. BACLESSEAND J. LOISELEUR. Sur les renseignements fournis par I’analyse systbmatique du sang de malades cancbreux au cours du traitement radiothbrapique, Compt. rend. SOC.de biol. 128: 692-694, 1938. Absorption of the products of tissue necrosis produces various changes in the blood which are arbitrarily grouped together to provide an “ index of histolysis ” (Loiseleur: Compt. rend. Soc. de biol. 120: 1038, 1158, 1935. Abst. in Am. J. Cancer 27: 362, 1936). During radiotherapy of tumors, considerable variations in the index occur as a result of tissue destruction. A high index before treatment seems to be an unfavorable prognostic sign; radiotherapy does not reduce the index to its normal value. When the index before treatment is not high, radiotherapy produces an increase-due to various causes-which subsides in about a week; thereafter the variations in the index depend on the radiosensitivity of the tumor. With tumors of high radiosensitivity there is a secondary rise of the index, sometimes to extremely high values. With tumors of moderate sensitivity the index always rises, but to a less extent, while with tumors of low sensitivity and with inflammatory lesions there is a return to the initial level without a secondary rise. Sometimes, however, as a result of factors as yet ill-defined, the parallelism between the index of histolysis and radiosensitivity is effaced, so that it is not permissible to interpret variations in the index with certainty. L. FOULDS

Combined Roentgenotherapy and Ultra-short Wave, I. ARONSAND B. SOKOLOFF.Am. J. Surg. 36: 533-543, 1937. It has been held that radiosensitivity is increased in the presence of a rapid rise in respiratory metabolism (Lambert: Arch. de biol. 44: 621, 1933. Abst. in Am. J. Cancer 20: 444, 1934). In a series of 30 tumors of various types the authors sought to bring about this effect by the use of ultra-short waves (6 meters), which it was believed would augment the blood supply of the neoplastic tissues through hyperemia and vasodilation and thereby raise the respiratory metabolic rate. The short-wave therapy was given either just before or in between the two halves of a daily x-ray dose, and thermal effects were avoided as far as possible. The authors are unable to say whether the radiosensitivity was increased in these cases, but lessening of skin injury was observed in some patients and in some an analgesic effect was obtained. Short waves were found to be of distinct benefit in postoperative suppuration. There was no indication that they stimulated the growth of the neoplasm in any instance. References are appended.

Roentgen Irradiation as an Adjunct to Surgical Treatment of Piloddal Cyst, R. MANGES SMITH. Am. J. Roentgenol. 38: 308-311, 1937. Six cases of pilonidal cyst were treated with roentgen radiation either before or after operation, with a view to preventing hair growth from interfering with healing and to control infection. The immediate results were favorable but, as the author states, sufficient time had not elapsed to prove the efficacy of this form of therapy.

Electronvgicpl Treatment of Neoplastic Disease, H. C. MYERS. M. Rec. 145: 469- 470, 1937. Brief general discussion.

Prophylaxis and Medical Treatment of Cancer, J. SMITHLINE.M. Rec. 146: 206210, 230, 1937. The author’s theory is that all neoplasms originate in a state of deranged and per- verted nutrition and that the logical method of prophylaxis and treatment is dietary, hygienic, and medical. DIAGNOSIS AND TREATMENT 609

Neurovascular Reactions during Polyvalent Hormone Therapy of Malignant Tumors in Experimental Animals and in Man, F. CAILLIAUAND E. JACOBS. Reactions biologi- ques neuro-vasculaires au cours de l’hormonotherapie polyvalente des tumeurs malignes exphimentales et humaines, Paris mCd. 2: 173-175, 1936. A worthless paper claiming the regression of tumors under treatment with polyvalent hormones, but giving no idea as to the types of these hormones. [Goldfeder found this hormone extract wholly without effect on malignant tissues cultivated in uitro (Am. J. Cancer 33: 560, 1938). Caillau later failed to substantiate his earlier results and de- clared the treatment to be useless. See following abstract.] EDWARDHERBERT, JR.

Method of Action of (‘Mstotrop,” H. v. MEYENBURG.Bemerkungen zur Wirkungs- weise des “ Aristotrop,” Schweiz. med. Wchnschr. 18: 7-8, 1937. Polyvalent Hormone Therapy and Neurovascular Changes in Cancer Tissue, F. CAIL- LIAU. A propos de I’hormonothCrapie multivalente et des modifications neuro- vasculaires dans le tissu canckreux, Schweiz. med. Wchnschr. 18: 73-74, 1937.

Further Remarks on the Method of Action of (( Aristotrop,” H. v. MEYENBURG.Noch- mals: zur Wirkungsweise des “ Aristotrop,” Schweiz. med. Wchnschr. 18: 94-95, 1937. Organotherapeutic Treatment of Cancer, F. CAILLIAU.A propos d’un traitement organotherapique du cancer. Bull. Assoc. franf. p. I’btude du cancer 27: 6-7, 1938. Aristotrop apparently is the trade name of a polyvalent hormone extract for which definite value in the treatment of cancer has been claimed. The clinical results and the histopathological changes in tumor tissue that succeeded such treatment were described in a series of papers by Blumenthal and his associates, Jacobs, Rosenberg and Cailliau (Schweiz. med. Wchnschr. 17: 640-645, 1936. Abst. in Am. J. Cancer 29: 160-162, 1937). Cailliau reported 100 per cent regression of transplantable animal tumors, and stated that the treated growths showed specific effects attributable to the therapy. Regressive changes occurred in the parenchyma, associated with a proliferative endarteritis and the appearance of numbers of large cells in the media of the vessels. These are supposedly sympathetic nerve cells. The walls of the vessel become thickened and finally obliterated. The first of the papers, listed above, by v. Meyenburg, contains a number of critical remarks regarding Cailliau’s description. Effects produced in animal tumors may not always be duplicated in human cancers, and a 100 per cent result in a biological experiment should always arouse suspicion. The so-called specific lesions were not evident to v. Meyenburg in the very histological preparations upon which Cailliau based his descriptions and theoretical considerations. Close examination of more than a hundred untreated human cancers revealed in 56.5 per cent of the cases changes in the arteries of the tumors comparable in every way to those regarded by Cailliau as specifically caused by Aristotrop. It is noteworthy that no changes were observed in the tumors of 3 patients who received Aristotrop, and all succumbed as a result of continued growth of their cancers. Cailliau in an attempt to answer v. Meyenburg’s objections insists upon the validity and applicability to man of the results of experiments with animal tumors. The tumor used originated in the uterus of a rat, is readily transplantable, and frequently gives rise to metastases. Although the number of cures in later experiments was no longer 100 per cent, a relatively high figure was always attained. This tumor appears preferable to tar tumors, which v. Meyenburg would use. Finally Cailliau again differentiates the arterial lesions with proliferation of sympathetic nerve elements in the media as a process distinctive from the non-specific type of endarteritis which v. Meyenburg demonstrated to be so common in non-treated tumors. v. Meyenburg’s concluding remarks stress again his disinclination to accept the findings reported by Cailliau. Cailliau, in his latest paper, admits that he has failed to confirm his earlier results. Renewed clinical and experimental observations have proved conclusively that poly- 610 ABSTRACTS valent hormone therapy is valueless in the treatment of cancer. The histological criteria of tumor changes first ascribed to this form of therapy were not found in later experiments. He cautions against utilizing his previously published evidence as a scientific basis for the administration of a useless remedy. MILTONJ. EISEN

Metotrop Treatment of Cancer, M. BR~GLI.Beitrag zur Krebsbehandlung mit dem Aristotrop, Schweiz. med. Wchnschr. 18: 95-96, 1937. Polyvalent hormone therapy (Aristotrop) proved valueless as a method of treatment of human cancer. Four case histories are included. MILTONJ. EISEN

Clinical Obeerpations on Arirtotrop "reatmcmt of Cancer in Advanced Stager, A. SIMONS.Klinische Beobachtungen Uber die Einwirkung der Aristotrop-Behandlung auf Krebskranke in vorgeschrittenem Stadium, Schweiz. med. Wchnschr. 18: 739- 742, 1937. The author reports a favorable palliative effect of Aristotrop (a polyvalent hormone extract) in 120 cases of advanced cancer, in which other therapeutic measures were deemed hopeless. The improvement was chiefly symptomatic, shown by diminished pain in the region of both the primary tumor and the metastases and a more favorable general condition. The period of observation was one year, but the amelioration rarely lasted more than three to six months. Actual tumor regreadon never occurred, although in a number of stenosing growths of the intestinal tract the degree of stenosis diminished to some extent. It is suggested that Aristotrop be administered as an accessory therapeutic agent in cases amenable to accepted methods of treatment. It should not be employed directly during radiation therapy, as untoward reactions such as fever or collapse may follow and impede the further use of x-rays. Several case histories are cited as illustrations of the favorable effects obtained with this type of hormone therapy. [See,however, preceding abstracts.] MILTONJ. EISEN

Organotherapy of Cancer, G. CASSAN.Traitement opothdrapique du cancer, Toulouse m6d. 37: 10-12, 1936. A vague article on the treatment of cancer by an extract of the duodenum, pancreas, liver, and spleen, called JBS (See Absts. in Am. J. Cancer 19: 103, 1933; 25: 187, 1935) and used as a compress, suppository, or salve. In 14 cases of cancer of the stomach, mediastinurn, colon, bladder, breast, and jaw, all inoperable and far advanced, improvement in the general condition of the patient and prolongation of life are said to have been obtained, Seven cases of gastric ulcer, radiologically demonstrated, were also treated, and in all the symptoms disappeared. Thus it is concluded, unconvincingly enough, that the method is beneficial in treating cancer and in preventing it by curing potentially cancerous ulcers. EDWA~HERBERT, JR.

THE SKIN Occupational Cancer of the Skin, from Annual Report of the Chief Inspector of Factories and Workshops for the Year 1937, published by His Majesty's Stationery Office, London, 1938. The portion of this Report dealing with industrial dineases in Great Britain contains the following section upon occupational cancer of the skin. Epitheliomatous Ulceration: The distribution of casea in relation to the causative agent and industry is given in the following table: THE SKIN 611

Causative Agent and Industry I 1937 1936 1935 1934 1933 Pitch and tar Patent fuel worke...... 311 31 27' 321 Tar distilling...... 59 424 48' 39 Gas works...... 15' 13O 19' 16' Other industries...... 9 7' 7' 71 Paraffin Shale oil worke...... - 3 3' 3' Mineral oil Cotton mule spinning...... 63s 411' 62.0 3w Other industries...... 61 5' 5' 7' Total...... 183'1 l7Oa I 143"

The principal figures relate to cases; the raised figure8 to deaths. The increase in the number of notified cases in connection with tar distilling is attributable to the increase in the number of factories adopting voluntary periodic medical examination. E. L. KENNAWAY

Skin Cancer and Its Treatment, V. MCDOWALL.M. J. Australia 2: 210-218, 1937. The author follows a general discussion of cutaneous cancer and precancer, and their treatment, with a statement of the results of radium therapy in the Brisbane (Australia) General Hospital for 1929-1933. In the four-and-a-half-year period, 390 squamous-cell cancers were treated, including 193 involving the lip but originating in the skin. At the time of the report 234 patients were free of symptoms, 20 were alive with local recurrences, and 5 with secondary extension of the disease; 40 had died of cancer, and 42 of other causes; 49 were untraced. Of 26 patients with transitional-cell cancer, 21 were symptom-free, 1 was alive with a recurrence, and 4 had died of other causes or were untraced. Patients with basal-cell carcinoma numbered 440. In this group there were 310 free from symptoms, 19 were alive with local recurrence, 60 had died of other causes, 8 had died of cancer, and 43 were untraced. Five cases of melanoma were treated, with one death from the disease. One hundred and fourteen cases of hyperkeratoses were also treated. The author prefers interstitial radium therapy for rodent ulcers exceeding 2 or 3.mm. in depth and for all squamous carcinomata, with surgical excision of palpable lymph nodes followed by radium therapy when cancer is found microscopically. Carcinoma of the Skin and Lip, E. H. MOLESWORTH.M. J. Australia 2: 218-221, 1937. The author condemns the use of radium plaques, especially without filtration, for akin carcinoma, and recommends roentgen therapy for both basal-cell and squamous- cell lesions. He has also used roentgen therapy for carcinoma of the lip, according to a technic reported previously (M. J. Australia 1: 752, 1934. Abst. in Am. J. Cancer 23: 158, 1935), with favorable results (see also Belisario: M. J. Australia 1: 91, 1937. Abst. in Am. J. Cancer 33: 472, 1938). Some Noterr on the Treatment of Epithelioma with Radon, J. H. T. DAVIES. Brit. J, Dermat. & Syph. 49: 279-283, 1937. A series of 144 cases of epithelioma was treated by radon implants. There were 115 basal-cell and 29 squamous-cell tumors. It is difficult to reconcile the figures given in the text with those in the tables, but the results were favorable, especially when the lesions were small. For basal-cell carcinomas the percentage of cures ranged from 100 per cent for lesions measuring less than 1 cm. in diameter to 60 per cent for those over 20 cm.; for squamous-cell carcinoma the range was from 100 per cent for lesions measuring less than 1 cm. to 50 per cent for those between 10 and 20 cm. The distinction be- 612 ABSTRACTS

tween basal and squamous types was based solely on clinical evidence, and the paper is therefore of much less value than if a biopsy had been done.

Treatment of Epitheliomas of the Nasolabial Fold, 0. N. MELAND. Am. J. Roentgenol. 38: 730-739, 1937. Epitheliomas of the nasolabial fold are slowly growing localized lesions, usually insignificant but responding to inadequate treatment by progressive and destructive growth. Of a series of 43 cases analyzed by the author, 29 were basal-cell tumors, 2 were of the squamous-cell variety, 1 was of mixed type, and in the others histologic diagnosis was not obtained. Twenty-three of the tumors were recurrent after treatment elsewhere. For the primary growths the author advises protracted fractional radium therapy at a distance, given over a fairly large area. This is applied in the form of platinum needles arranged on a felt pad from 0.5 to 1.0 cm. thick. The total dose is 2000 to 3000 mg. hours. Protracted roentgen therapy gives similar results. The same technic may be employed for recurrent growths, but necrosis of cartilage and bone is likely to result here due to interference with the nutrition of the tissues by earlier irradiation, fulguration, or surgery. In such cases electrocoagulation is indicated. " Permanent healing " (one to twelve years) was obtained in 28 of the author's series-the cures being about equally divided between primary and recurrent cases. In 12 patients healing failed to occur or there was a recurrence. Three cases failed to heal on account of radionecrosis but the carcinoma was destroyed. The significant features of the cases are presented in tabular form and there are pictures of patients.

Cancer of the Eyebds, G. A. ROBINSON.Am. J. Roentgenol. 38: 743-745, 1937. Three examples of cancer of the eyelid treated by radium are recorded. These occurred in a series of 200 cases, for which however the results are not given. Inter- stitial therapy with needles or gold radon implants is preferred to surface irradiation.

Naevus Lipomatosua Subepidermalls seu Superficialis Cutis, H. M. ROBINSONAND F. A. ELLIS. Arch. Dermat. & Syph. 35: 485-488, 1937. A case of nevus is recorded with fat cells in the cutis. The lesions occurred on the arms and in the sacral and coccygeal regions. Histologic examination showed a slight increase in the keratin layer, a rather marked acanthosis, and saw-toothed or rounded uneven interpapillary pegs. The basal layer showed some hyperpigmentation. Just below the pegs and throughout the entire cutis were bands of fat cells occurring in irregular groups, which appeared in some instances to be contiguous to the subcutaneous fat. The authors could find in the literature only two cases of nevus with fat cells in the cutis proved by biopsy (Kromayer : Allgemeine Dermatologie, Berlin, Gebrilder Born- traeger, 1896, p. 185; Hoffmann and Zurhelle: Arch. f. Dermat. u. Syph. 130: 327, 1921). Photomicrographs are included, and a bibliography.

Multiple Glomus Tumors of the Order of Telangiectases, F. D. WEIDMANAND F. WISE. Arch. Dermat. & Syph. 35: 414-426, 1937. A woman of thirty-five had groupb of small bluish vascular lesions scattered over the body. Histologic study of one of the lesions showed it to consist for the most part of cavernous blood spaces, surrounded by a mantle of epithelioid cells. No nerve tissue was demonstrable. In spite of this, and though the lesions were painless and atypical in number and distribution, the authors regard them as glomus tumors. They believe they are to be accounted for by telangiectases of glomi, lacking in nervous tissue. Photomicrographs are included. THE BREAST 613

Xanthoma of the Skin and Larpnr Asmciated with Carcinoma of the Stomach and a Regressive Xmthoma of the Pons, F. D. WEIDMANAND H. W. SCHAFFER.Arch. Dermat. & Syph. 35: 767-814, 1937. A young man with xanthoma of the skin and of the larynx was found at autopsy to have, also, a regressive xanthoma in th’e pons and an adenocarcinoma of the stomach with metastases to the liver and regional lymph nodes. The carcinoma in this case was not xanthomatous, but the author has collected from the literature a number of cases of xanthocarcinoma which he discusses at length. The occasional association of cancer and lipoidosis, as in the author’s case, calls attention to the r8le of cholesterol in cancer and this is briefly discussed. Photomicrographs and a bibliography are included. Darier’s Disease with Malignant Transformation, H. CHARACHE.Arch. Dermat. & Syph. 35: 480-484, 1937. A negro forty-five years old had a scaly rash over the body, swelling of the legs and scrotum, and enlarged inguinal nodes. The skin condition had developed over a period of twelve years but enlargement of the nodes had been noticed only recently. One of these was removed, as was a small section of skin from the leg. Examination led to the diagnosis of Darier’s disease (keratosis follicularis) with malignant change. Autopsy was not permitted. The author could find only one case of Darier’s disease with malignant transformation in the literature (Wende: J. Cutan. Dis. 26: 531, 1908). Photo- graphs of the patient but no photomicrographs are included. Epithelioma of the Hose Caused by a Streptothrix, C. GARGANO.Su di un caso di epitelioma del naso prodotto da una Saprolegna, Ann. ital. di chir. 15: 335-342, 1936. Gargano previously reported lesions with anatomical characteristics and many clinical features of neoplasia, which regressed either spontaneously or after seemingly inadequate surgery (Arch. ed atti d. SOC.ital. chir. 37: 709, 1931). This unusual course prompted histologic investigation with special stains which demonstrated the presence of filamentous formations, interpreted as mycelia. The author holds that causes other than neoplasia can induce changes in the skin similar to epithelioma but the subsequent course in these cases belies the latter diagnosis. A case is presented in which the clinical characteristics of the lesion led to a diagnosis of epithelioma of the nose and biopsy showed the structure of squamous carcinoma. Beneath the epithelial infiltrations was an amorphous layer formed by hemorrhage intermingled with a third layer containing numerous filaments with all the characteristics of mycelia. Operation was refused and the lesion regressed after intense iodine therapy. Two photomicrographs are included. ADOLF MELTZER

THE BREAST

Chronic Cystic Mastitis (Apocrine Gland Cysts) and Carcinoma, H. BERNINGAND J. BUCKER. Mastopathia cystica (apokrine Drtisencysten) und Carcinom, Virchow’s Arch. f. path. Anat. 298: 728-742, 1937. Of 2283 persons undergoing breast operations, 33.8 per cent showed carcinoma, 21.8 per cent adenoma, 17.4 per cent fibrosis, 16.1 per cent chronic cystic mastitis, and 10.9 per cent other conditions. In 64 cases there were both chronic cystic mastitis and carcinoma, that is, 8.3 per cent of all the carcinomas were associated with chronic cystic mastitis. The writers accept as a histological criterion for apocrine glands the eosinophilic granules, and they show that chronic cystic mastitis is structurally a cystic change of these glands, which they believe to be present in every normal breast, and which by the same criterion they succeeded in demonstrating in 42 of 50 normal breasts by means of serial sections. There are no illustrations but several references are given. EDWARDHERBERT, JR.

Vertebral Metastases in Carcinoma of the Breast, J. DUCUINGAND BURSZTYN.Les metastases vertebrales dans le cancer du sein, Toulouse mkd. 37: 173-188, 1936. A general discussion without new material or illustrations. EDWARDHERBERT, JR. 614 ABSTRACTS Carcinoma of the Breut with Peculiar Cutrneour Metortuer: Report of a Cue, C. D. FREEMANAND F. W. LYNCH. Arch. Dermat. & Syph. 35: 643-652, 1937. A patient who had had a bilateral mastectomy for painless diffuse enlargement confined to the right breast developed, the following year, a vesicular eruption over the neck and chest, the upper portion of the abdomen, and the right arm. Microscopic examination showed sharply circumscribed areas of adenocarcinoma filling the lumen of the blood vessels. There was central necrosis of many of these cellular masses, leading to the development of small cystic lesions resembling vesicles. In some areas in which the necrosis had not advanced to liquefaction there was a superficial resemblance to the picture of comedo-adenoma of the breast as described by Bloodgood. Photomicrographs show the malignant tissue within the dilated vessels. References are appended.

Radiotherapy in Crncer of the Breut, Excluding Recurrenceti and Metastases, P. HERMET. La radiothbrapie dans le traitement du cancer du sein (A I’exclusion des rkidives et des mbtastases), Paris mbd. 1: 233-242, 1936. The opinion is expressed that small, easily operable breast carcinomas should be removed immediately without radiotherapy, while the.larger or fixed tumors, or those with obvious lymph node metastases, should have preoperative irradiation with either x-rays or radium. When patients refuse operation, and when operation is contraindi- cated by age or because of metastases or unrelated pathological conditions, radiotherapy alone should be used, but except under these conditions there is no justification for thus limiting the treatment. From a review of the literature it is concluded that in general the best results are obtained by combining surgery with preoperative and postoperative irradiation. There are no illustrations. EDWARDHERBERT, JR.

Resection of the Digitations of the Serratue Anterior in Amputation of the Breast for Cancer, J. DUCUING.La rtsection des digitations du grand dentelb dans I’amputation du sein cancbreux, Toulouse mbd. 37: 689-696, 1936. Ducuing recommends resection of the digitations of the serratus anterior back to the mid-axillary line in a radical mastectomy for carcinoma, since there is a group of lymph nodes, the so-called nodes of Bartels, within the muscular tissue of the fourth digitation. These lymph nodes receive drainage from part of the lateral portion of the breast and are therefore considered a possible route for metastasis. No figures are given as to the results of the operation. Four drawings are included. EDWARDHERBERT, JR.

Uee of a Muecle Pedicle Flap for Revontion of Swelling of the Arm Following the Radical Operation for Carcinoma of the Breart, W. F. RIRNHOFF,JR. Bull. Johns Hopkins Hospital 60: 369-371, 1937. The method described in the title has been used successfully in 4 cases.

Papilloma of the Breast, E. C. SAUCHELLI.M. Rec. 146: 111-112, 1937. A brief discussion with report of a typical case.

Papilloma8 of the Breut. Study of 273 Specimenr, D. H. KAUMPAND A. E. MENDES- FERREIRA.J. Lab. & Clin. Med. 22: 681-686, 1937. A study was made of the nuclear-nucleolar ratio in 273 mammary papillomas. Of these 45.6 per cent were claeeified as papillary adenoblastomas (malignant); 19.3 per cent revealed secondary cytoplasia, which is regarded as an intermediary stage between malignant and benign; 35.1 per cent were benign papillary adenocytomae. The nuclear- nucleolar ratio was found to be generally reduced in the malignant cells as compared with the others. References are appended. ORAL CAVITY AND UPPER RESPIRATORY TRACT 615 THE ORAL CAVITY AND UPPER RESPIRATORY TRACT Interstitial Rndium Trentment in Carcinoma of the Lip :A Review of Seventy-one Casee, C. DE MONCHAUX.M. J. Australia 2: 221-225, 1937. Seventy-one patients with carcinoma of the lip received interstitial radium therapy, the average dose being between 1100 and 1200 mg. hours. One additional patient was treated by surface application alone. Fifty-seven of the cases were classed as early; i.e., the lesion was either quite superficial or did not exceed 1.0 cm. in diameter and there was no clinical evidence of disease in the lymph nodes. In only 4 of these cases was there subsequent node involvement (4 cases, however, were not traced) and in 2 of these this occurred in spite of a routine block dissection. Of the 57 patients, 42 were alive and well, but the majority of these had been treated less than five years before; 4 patients had died of cancer and 3 were alive with the disease; 4 were dead from other causes. Of 15 patients with advanced lesions, 9 were alive and well, 1 was alive with cancer, and 5 had died. Trentment of Epitheliomn of the Lip by Electrodesiccation. Technic and Prow Report of Results during the Past Five Years, H. MORROW,H. E. MILLERA~D L. R. TAUSSIG.Arch. Dermat. & Syph. 35: 821-830, 1937. The authors have treated 139 patients with early epithelioma of the lip by curettage followed by electrodesiccation. Sixty-six patients were without recurrence for periods varying from six months to five years after treatment.

UnudAtrophic Scirrhous Carcinoma of the Tongue, J. ,DUCUINGAND L. DUCUING. Un cancer de la langue peu frequent: le squirrhe atrophique, Toulouse. med. 37: 645-646, 1936. A woman sixty-six years of age had a tumor of the tongue which had been present for four years. Biopsy showed it to be a basal-cell epithelioma with an abundant fibrous stroma. It was called an atrophic scirrhous carcinoma. There are no illustrations. EDWARDHERBERT, JR. Protective Shields in Radiation Therapy of Intraoral Cancer, A. J. ACXERMAN.Am. J. Roentgenol. 38: 746757, 1937. The author describes a method of protective shielding against gamma radiation directed toward intraoral lesions. The shields are composed of vulcanite rubber and lead and vary in form according to the structure to be protected. Lead shields for protection against roentgen irradiation are also described.

Pedunculated Fibroma of the Nasal Septum, W. L. SIMPSONAND J, D. EVANS. Ann. Otol., Rhin., & Laryng. 46: 527-530, 1937. Report of a case with photomicrographs of the lesion. Malignant Disease of the Sinuses and Nasopharyxu, in the Small Hospital, F. T. HILL. Ann. Otol., Rhin. & Laryng. 46: 158-168, 1937. The author points out some of the errors encountered in the management of malignant tumors of the sinuses and nasopharynx and the more obvious handicaps to successful treatment in the small hospital, illustrating his remarks with brief case hirtoriea. The most common errors are failure to make a correct diagnosis, overlooking the nasopharynx as a possible site of the primary lesion, omission of proper roentgen and pathologic studies, and over-regard for the cosmetic result at the expense of adequate removal. The greatest handicaps due directly to the small hospital are the inferiority of the microscopy and lack of expert opinion as to postoperative irradiation. The first of these may be met, except where frozen sections are required, by sending the slides to a larger hospital with more adequate facilities. As more tumor clinics are established throughout the country these difficulties will diminish. [The errors of omission and commission cited by the author are unfortunately not confined to the small hospital. They occur even in the largest and most famous.-E~.] 616 ABSTBACTS

Treatment of Carcinoma of the Hypopharynx, M. LALLEMANTAND C. LOISEAU. A propos du traitement du cancer de I'hypopharynx, Paris mhd. 2: 150-152, 1936. This is a general discussion containing no new material. EDWARDHERBERT, JR.

Malignant Tumors of the Base of the Anterior pill.r of the Fauces, J. DUCUINGAND L. DUCUING.Les tumeurs malignes du pied du pilier anthrieur du voile du palais, Toulouse mhd. 37: 205-222, 1936. Five examples of tumor arising at the base of the anterior pillars of the fauces were observed among 208 pharyngeal neoplasms. All were in men who were smokers and drinkers but in none was there any evidence of syphilis. The ages of the patients varied from fifty to sixty-five years. Histologically the lesions were squamous-cell epitheliomas, 4 with cornification. In 3 there was macroscopic lymph node involvement. These three patients received radiotherapy and at the time of the report were still alive but unimproved. One patient without node involvement was treated with radium and died two years later. The other was treated by electrocoagulation plus radiotherapy and was symptom-free after three months. Two drawings are included. EDWARDHERBERT, JR.

Problems Involved in the Diagnosis and Treatment of Malignancies of the Nasal Accea- sory Sinuses, F. L. LEDERER. Wisconsin M. J. 36: 263-268, 1937. A general discussion with no case reports.

Treatment of Malignant Tumors of the Madllarp and Ethmoid Sinuses, W. F. WASSINK. De behandeling van de kwaadaardige gezwellen van de bovenkaak en van de zeef- beencellen, Nederl. tijdschr. v. Geneesk. 80: 1201-1210, 1936. One hundred and six cases of malignant tumors of the maxillary and ethmoid sinuses are reported, of which 76 were carcinomas and 30 sarcomas; 43 cases were seen before 1922 and 63 later. During the latter period the treatment had become standardized as radical operation followed by radiotherapy. Of the 63 cases treated, 14 showed metastases when first seen. Of the remaining 49, 60 per cent were cured. EDWARDHERBERT, JR.

An Unusual Tumor Involving the Maxillary Antrum, B. L. BRYANT. Arch. Otolaryng. 25: 581-584, 1937. A cystic tumor with a bony capsule was removed from the maxillary antrum of a twenty-eight-year-old man. It is believed to have been an adamantinoma, though there was no distortion or bulging of the normal bone at any point except for a small area of erosion in the floor of the antrum. Microscopic examination showed dense fibrous tissue lined by several layers of circular epithelial cells. There was diffuse round-cell infiltration with some polymorphonuclear leukocytic reaction. Fibrous connective tissue was increased. No photomicrographs are reproduced.

Case of Benign Giant Cell Tumor of the Ethmoid Labyrinth with a Review of the Literature, M. WATTLES. Ann. Otol., Rhin. & Laryng. 46: 212-222, 1937. Only 7 instances of benign giant-cell tumor of the ethmoid labyrinth were discovered by the author in the literature from 1860 through 1935. An additional case is recorded in a twenty-one-year-old man, who complained of protrusion of the left eye and headache following a Mow to the eye. An external exenteration of the left ethmoid labyrinth was done. Microscopic examination of the tissue, which was very vascular, showed spindle cells, round cells, and giant cells. Embedded in the stroma of the spindle cells were many spicules of new-formed bone. The diagnosis was benign giant-cell tumor. Six weeks later there was some reduction in the proptosis of the eye, the eye movements were good, and there was no evidence of tumor on roentgen examination. The literature of benign giant-cell tumors is reviewed, with a bibliography. Photo- micrographs are reproduced. THE EYE 617

Recurrent Rhabdomyoma of the Left Vocal Cord, LAMANNA.Rezidiviertes Rhabdo- myom des linken Stimmbandes, Virchow's Arch. f. path. Anat. 298: 566-573, 1937. A man fifty-seven years of age had a small tumor removed from the left vocal cord, which was found to be a rhabdomyoma. Cross striations were demonstrated only with difficulty. Seven years later another tumor was removed from the same location. This differed from the first in that no striations were seen and the cells were much less differentiated, with a greater tendency to unrestrained growth. By special stains, however, and comparison with the first tumor it could be seen that they were closely related. Three photomicrographs are included. EDWARDHERBERT, JR.

Results of Radiation Therapy in Cancer of the Mouth, Pharynx, and Larynx. Pre- liminary Observation, H. YAMAKAWA,T. NAKAMURAAND H. OTSUKA. Uber die Ergebnisse der Strahlenbehandlung von Mundhole-, Rachen- und Kehlkopfkrebs- Eine provisorische Zusammenstellung, Gann 31 : 18-31, 1937. X-ray or radium treatment was employed in 112 patients with cancer of the mouth, pharynx, or larynx. The local condition was classified according to the extension of the tumor. There were 23 cases in Stage I (localized growth or one with operable metastases), and 89 in Stage I1 (tumor with invasion or with inoperable metastases). After a period varying from six to twenty-four months 29 patients (18 of Group I and 11 of Group 11) remained free from disease. An apparent cure in 3 patients was followed by recurrence of the tumor and metastases, and 4 cured patients died of other diseases. Palliation was obtained in 37 cases. The large majority of the tumors were squamous- cell cancers. Various forms of sarcoma were observed 14 times among the 39 pharyngeal tumors, and there were 4 cures in this group. A description of the technic used, photographs of patients before and after treatment, and a bibliography are included. MILTONJ. EISEN

THE EYE

Prognosis in Uveal Sarcoma, H. DENECKE. Beitrag zur Prognose des Uvealsarkoms, Klin. Monatsbl. f. Augenheilk. 97: 594-599, 1936. The results in 36 cases of uveal sarcoma in which enucleation was carried out within the past twenty years are reported. Almost half of the cases occurred during the sixth decade; the youngest patient was twelve, the oldest seventy-nine. There were at the time of writing 18 patients still living and 18 had died, 14 of metastases and 4 of other diseases. Of the 14 who died with metastases, 12 died within five years, 1 after six years, and 1 after fourteen and a half years. The 4 who succumbed to other diseases died less than five years after operation. Of the 18 patients still living, 4 had lived over eleven years, the longest survival being thirteen years; 4 had lived between five and nine years, and 10 less than five years. Seven patients had extension of the tumor through the eyeball at the time of operation, and yet there were no local recurrences. Of these 7 patients, 4 died of metastases, 1 was alive fifteen months after operation, while the other 2 were alive twelve and thirteen years. Thus extension of the tumor is not necessarily a hopeless sign. There are no illustrations, but several tables and references are given. EDWARDHERBERT, JR.

Symmetrical Tumors of the Iris, 0. KURZ. Symmetrischer Iristumor, Klin. Monatsbl. f. Augenh. 98: 476-486, 1937. A girl twenty-one years of age had a small nodule on the outer lower quadrant of the right iris. She had noticed it for several years and more recently had become aware of a similar but smaller nodule symmetrically placed on the left iris. There were no symptoms. A partial iridectomy was done on the right and the tumor was found to be a benign endothelioma, believed to have arisen from a remnant of the fetal pupillary membrane. One year later there was no sign of recurrence on the right side, or of growth of the nodule remaining on the left side. Three photographs and 2 photomicrographs are included. EDWARDHERBERT, JR. 618 ABSTRACTS

Reticulum-cell Sarcoma Metartatic to the Eye, W. BUSCHKE. Metastatisches Reto- thelsarkom des Auges, Klin. Monatsbl. f. Augenh. 98: 457-466, 1937. A man fifty-nine years of age had atypical abdominal symptoms and a detachment of the retina which was demonstrated ophthalmoscopically, but no sign of tumor was seen. Six weeks later he died and at autopsy a generalized reticulum-cell sarcoma was found which was primary in the ileum or the abdominal lymph nodes. In the left eye was a metastatic tumor which was unusual in that it was largely intravascular, occupying the vessels of the choroid and the ciliary body. Six camera lucida drawings are included. EDWARDHERBERT, JR.

Metartrsee in Both Eyer from a Breast Carcinoma, F. v. PAPOLCZY. Metastase eines Mammakarzinoms in beiden Augen, Klin. Monatsbl. f. Augenh. 97: 486-491, 1936. In the literature reports were found of 135 metastatic tumors in the eye, 65 per cent of which came from breast carcinomas. An additional case is reported. A woman forty-six years of age had a right radical mastectomy for carcinoma. One month later she experienced diminution of vision in the right eye, which soon became totally blind, with glaucoma. Enucleation was done and a metastasis was found identical histologically with the breast tumor. A similar tumor appeared in the left eye with signs of metastases throughout the body. Three photomicrographs and several references are included. EDWARDHERBERT, JR. Two Carer of Choroidd Meta6ta~e6from Carcinoma of the Braart, H. RIETH. Ueber zwei Fiille von Aderhautmetastasen bei Brustkrebs, Klin. Monatsbl. f. Augenh. 96: 369-370, 1936. Two cases are reported in women fifty-five and seventy-two years of age. Both had carcinomas of the right breast removed surgically with postoperative radiotherapy, and both later developed metastases to the right choroid, the first three years, and the second six years after operation. The first patient showed signs of generalized metastases and died. The diagnosis was verified at autopsy. An enucleation was performed on the second patient but she died six months later. There are no illustrations. EDWARDHERBERT, JR.

Cavemow Angioma of the Choroid, C. BRONS. Kavernbes Angiom der Chorioidea, Klin. Monatsbl. f. Augenh. 97: 43-51, 1936. A man forty-one years of age who complained of diminution of vision of the right eye was found to have a tumor of the choroid, which progressed over the course of a year to produce complete blindness. Enucleation was done and the tumor was found to be a hemangioma. In a review of the literature, which contains about 40 cases, several criteria are found which may help in arriving at a diagnosis clinically, although none of them is pathognomonic. These are (1) the presence of nevi in other parts of the body; (2) location near the optic disc and slow growth; (3) relatively early age of the patient; (4) grayish yellow color on retinal examination; (5) lack of signs of inflammation around the tumor; (6) widening of the surrounding vessels; (7) changes in the visual fields exceeding the actual size of the growth; (8) degenerative changes in the macula if this region is not involved in the tumor. Four photomicrographs are included. EDWARDHERBERT, JR.

Cane of Angiomatosie of the Retina, S. PREVEC. Ein Fall von Angiomatosis retinae, Klin. Monatsbl. f. Augenh. 96: 2W204, 1936. A woman forty-five years of age who had had progressive failure of vision of the right eye for fourteen years suddenly developed a diminution of vision of the left eye and examination showed an angiomatosis of the retina on that side. The right fundus could not be visualized because of a cataract. Further examination showed two tumors of the spinal cord. The presence of a congenital angiomatosis of both retina and spinal cord, corresponding to Lindau’e disease, then seemed probable. No follow-up is given. One roentgenogram ib included. EDWARDHERBERT, JR. THE EYE 619

Sarcoma of the Lacrimal Sac, K. VELHAGEN,JR. Sarkom des Triinensackes, Klio. Monatsbl. f. Augenh. 98: 38-42, 1937. A woman seventy-six years of age had a tumor in the region of the left lacrimal sac which had been there for forty years without change, but which had increased rapidly in size and had become painful during thelast two months. The tumor was believed to be cystic but on surgical removal was found to be a solid encapsulated fibroma with a spindle-cell sarcoma developing in one end. The patient was symptom-free three months later. Seventeen other cases of sarcoma of the lacrimal gland are found in the literature, with various histologic pictures. Three photographs, a photomicrograph, and several references are included. EDWARDHERBERT, JR.

Symmetrical TLUUOXVJof the Orbit, R. VOELKEL. Zur Frage der symmetrischen Orbital- tumoren, Klin. Monatsbl. f. Augenh. 98: 169-177, 1937. About 40 instances of bilateral orbital tumors have been reported in the literature, and 2 additional examples are here described. The first patient was a man twenty-four years of age, who had a progressive exophthalmos of two years' duration. Biopsy of the retrobulbar tissue showed Hodgkin's disease and later there was generalized enlargement of the lymph nodes. No follow-up is given. The second patient was a woman of forty-two years who had bilateral orbital tumors with thickening of the eyelids as well as evidence of a generalized lymph node enlargement, central as well as peripheral. Biopsy of the eyelid and of a lymph node showed a leukemic infiltration. The patient became rapidly worse and died with a terminal leukopenia, although previously she had had a normal blood count. Aschoff, who examined the sections microscopically, was unable to make a definite diagnosis, but considered the case an atypical one related closely to the leukemias. Five photographs and a drawing are included. EDWARDHERBERT, JR.

Formstion of Lymph nodules in Cavernous Hemnngiomas of the Orbit, F. Poos. Ueber die Bildung von Lymphkn6tchen in kavernasen Hiimangiomen der Orbita, Klin. Monatsbl. f. Augenheilk. 98: 466-476, 1937. It has been noted by several writers that orbital hemangiomas may contain numerous lymph nodules scattered throughout the vascular tissue. Two cases are described here. The first patient was a man forty-three years of age who had a right exophthalmos of five years' duration. An encapsulated hemangioma removed surgically was histologically typical, no lymph nodules being .present. In the second case a tumor was removed from the left orbit of a girl twelve years of age who had had exophthalmos for two years. This differed from the tumor in the first case in that it showed a great increase in fibrous and granulation tissue with plasma-cell infiltration and evidences of blood destruction in the form of iron-bearing pigment. There were also numerous separate and confluent lymph nodules, each with a well formed germinal center. Poos believes that these do not represent a mixed tumor with lymphatic and angiomatous elements, but rather an inflammatory process due to the irritation caused by the breaking down of the blood elements. In a sense it represents a spontaneous cure of the angioma, since it tends to obliterate it and stop its growth, Seven photomicrographs are included. EDWARDHERBERT, JR.

Differential Diagnosis of Intra-orbital and Retro-orbital Tumors, E. THIEL. Zur Diagnose und Differentialdiagnose der intraorbitalen und retroorbitalen Gesch- wlilste, Schweiz. med. Wchnschr. 18: 800-803, 1937. A general review of the symptomatology and treatment of intraorbital and retro- orbital neoplasms. Several case histories are included. MILTON J. EISEN

Adenoma hydradenoides of a Moll%Gland, A. HAGEDOORN.Adenoma hydradenoides einer Mollschen Drtlse, Klin. Monatsbl. f. Augenh. 96: 171-176, 1936. Two cases are reported. (1) A woman fifty-eight years of age had had a small tumor of the inner portion of the upper eyelid for ten years. A biopsy was taken and the re- 620 ABSTRACTS

mainder of the tumor was destroyed by diathermy. Six months later the eyelid was normal. (2) A man sixty-seven years of age had a tumor of the left lower eyelid of four years’ duration, with a recent increase in size. It was removed surgically and there was no recurrence, but the length of the follow-up is not given. Both tumors showed histologically the structure of an adenoma hydradenoides arising from a Moll’s gland. Two photographs, 8 photomicrographs, and several references are included. EDWARDHERBERT, JR. THE EAR

Painful Nodule of the Ear. Angiokeratoma of the ma,L. P~RINAND S. BOULLE. Le nodule douloureux de I’oreille. Angiokbratome du pavillon de I’oreille, Paris mkd. 1: 60-66, 1936. This is a general discussion based on a detailed study of 12 cases of painful nodule of the helix, 11 in men and 1 in a woman. The ages varied from twenty-five to seventy. This condition occurs as a small crusted lesion on the helix and is extremely painful on pressure. It grows for a period of several weeks and then remains more or less station- ary, never attaining any great size. Microscopically it shows hyperkeratosis, acanthosis, and an angiomatous proliferation of blood vessels in the subepithelial layers with numerous epithelioid cells and giant cells of the Langhans type. In many ways the lesion is similar to the glomus tumors, and some workers have demonstrated unmyeli- nated nerve fibers. Others consider it to be tuberculous in origin. Until the etiology is settled, the term angiokeratoma is considered satisfactory. The treatment of choice is surgical excision, but unless completely removed the lesion tends to recur. Malignant change has never been observed. A photograph, 3 photomicrographs, and several references are included. EDWARDHERBERT, JR. primllry Cholesteatoma of the Mastoid, L. B. BERNHEIMER.Ann. Otol., Rhin. & Laryng. 46: 453-455, 1937. A case of cholesteatoma of the mastoid without middle ear involvement in a man of twenty-nine is recorded. By a process of exclusion the authors conclude that it was a primary growth of congenital origin.

THE THYROID GLAND

Two Casee of Malignant Giant-cell Tumors of the Thyroid, B. MORPURCOAND A. BOBBIO. Due casi di tumore maligno giganto-cellulare della tireoide. Arch. per le sc. med. 61: 544-556, 1936. Two cases are described of malignant giant-cell tumors of the thyroid. The first patient, a woman sixty years of age, had had a goiter for twelve years which had grown slowly until two months before admission. She appeared with a hard, painless tumor on the right side of the neck, fixed to the skin and deep tissues. It was removed with a portion of adherent jugular vein and recurrent nerve. Two months later there was a recurrence and the patient died soon thereafter. The second patient was a man of seventy who entered in a state of imminent suffocation. He had had a goiter for seven years. At operation the trachea and esophagus were found involved in tumor. An attempt was made to relieve tracheal pressure but death occurred fifteen minutes after operation. Microscopically the tumor in the first case was found to contain numerous tumor giant cells. The smaller of these contained up to three nuclei and showed many mitotic figures including bizarre forms. In the ” monstrous ” cells amitotic activity prevailed. A marked exudative inflammation was also present, numerous polymorphonuclear leukocytes being found among the islands of tumor and about hemorrhagic foci. The second case showed no evidence of thyroiditis. The parenchyma of the gland was ex- tensively involved by the tumor. Considerable colloid was in the process of being enveloped by foreign-body giant cells. The latter, macrophages, and true tumor giant cells are the three types of giant cells to be found in thyroid tumors. Six photomicrographs are included and there is a bibliography of 11 papers. ADOLPH MELTZER INTRATHORACIC TUMORS 62 1

INTRATHORACIC TUMORS Cancer of the Human Lung and Animal Experiment, J. ARGYLLCAMPBELL. J. In- dust. Hyg. & Toxicol. 19: 449-462, 1937. This paper is a review of experimental investigations on pulmonary cancer, the results of which the author considers applicable to man. He believes that the available evidence supports the " irritation " theory for lung carcinoma and indicates that there may be several irritants coming from the environment, as well as several inherent factors, as heredity, capable of playing a r81e. A comprehensive bibliography is appended.

Clinical Aspects of Cancer of the Lung, N. G. MARKOFF. Zur Klinik des Lungen- carcinoms, Schweiz. med. Wchnschr. 18: 736-738, 1937. Sixty-one cases of lung cancer were observed between 1917 and 1937. The clinical and pathological findings are described and discussed, but no new material is added. Photomicrographs of metastatic tumor cells seen in material obtained by sternal punc- ture are reproduced. MILTONJ. EISEN

Occupational Cancer of the Lung. L. TELEKY.J. Indust. Hyg. & Toxicol. 19: 73- 85, 1937. The author reviews the subject of pulmonary cancer in chromate workers and in the miners of Schneeberg and Joachimsthal but records no new investigations. [See his paper on cancer in chrome workers (Deutsche med. Wchnschr. 62: 1353, 1936. Abst. in Am. J. Cancer 30: 385, 1937); also Pirchan and Sikl: Am. J. Cancer 16: 681, 1932.1 A bibliography is appended.

Irregularities of the Pulse with Lung Tumors, A. W. C. C. KAMERLINGAND C. L. C. VAN NIEUWENHUIZEN.Polsonregelmatigheden bij longgezwellen, Nederl. tijdschr. v. Geneesk. 80: 5726-5730, 1936. Of 36 patients with primary carcinoma of the lung, 8 showed cardiac irregularities apart from extrasystoles; 6 showed auricular fibrillation, including 5 with paroxysmal tachycardia of sinus origin and one with paroxysmal ventricular tachycardia. Often these irregularities are the first symptoms of lung tumors. They are to be explained by simultaneous stimulation of the vagus and the sympathetic nerves, which has been shown experimentally to cause paroxysmal tachycardia. There are no illustrations. EDWARDHERBERT, JR.

Primary Carcinoma of the Trachea with Cutaneous Carcinomatods, E. L. KEENEY. Bull. Johns Hopkins Hosp. 61: 411-420, 1937. A man of seventy-three was admitted to the hospital with symptoms referable to the lungs and five small subcutaneous nodules on the chest and over the right scapula. A diagnosis of bronchial carcinoma with metastases was made, and the carcinomatous nature of the subcutaneous nodules was proved by biopsy. Death occurred forty-five days after admission and in this interval the original nodules had enlarged and new ones had appeared until the skin of the chest anteriorly and posteriorly was peppered with them and some were present also over the abdomen. None was ulcerated. Au- topsy revealed a carcinoma of the trachea with widespread metastases. The author attributes the cutaneous metastases to invasion of the fascia1 lymphatic plexus and up- ward extension through the lymphatic tributaries. References are appended.

Carcinoma of the Bronchus and Its Treatment, N. A. WOMACK.Wisconsin M. J. 36: 711-718, 1937. Attention is again called to the increasing frequency of bronchial carcinoma, and diagnosis and treatment are discussed. Two hundred cases have been seen in the last fifteen years in the Chest Service of the Barnes Hospital, St. Louis. Of 44 autopsied cases in which the site of origin could be determined, 23 arose in a major bronchus and 21 in a minor bronchus or in the periphery of the lung. When the origin was in a major bronchus, the duration of life from the onset of symptoms to the time of death averaged 622 ABSTRACTS

26.3 months, while patients with tumors arising in the periphery of the lung lived on an average of only 7.3 months. Metastasis to the brain was observed in 23 per cent of the author’s series and in many of these cases pulmonary symptoms were so insignificant that a primary brain lesion was suspected. There was involvement of the suprarenals in a third of the patients coming to autopsy and of the kidneys in 26 per cent. The period of survival bore a direct relation to the degree of cellular maturity in the tumor. Those tumors with cells for the most part resembling adult ciliated cells, goblet cells or squamous epithelium were regarded as Grade I and the average survival period for patients in this group was 22.6 months. Less differentiated tumors in which the cells showed a tendency to arrangement in pavement-like groups constituted Grade I1 and here the survival period averaged 16 months. Grade I11 tumors were made up of cells that to a large extent resembled those of the basal epithelial layer. In this group fell most of the so-called round-cell carcinomas. These patients lived for an average of 12.8 months. A brief bibliography is appended. No photomicrographs are included.

New Method of Radium Application in Cancer of the Bronchue, J. J. PRESSMANAND C. K. EMERY.Ann. Otol. Rhin. & Laryng. 46: 314-326, 1937. The authors’ method of radium application in bronchial carcinoma consists in the implantation of long hollow tubes containing radium needles so that they till the entire length of the main stem bronchus and portions of the trachea. The tubes themselves are of platinum inserted in aluminum containers of different design. A preliminary pneumothorax overcomes the danger of massive collapse and diminishes the possibility of hemorrhage. The technic of insertion and the management of the patient while the tubes are in position and after their removal are described. Illustrations are included. Total Pneumonectomy for Cancer of the Lung, J. LBREBOULLET.La pneumectomie totale pour cancer du poumon, Paris m6d. 1: 45-48, 1936. A general discussion and brief review of the literature. EDWARDHERBERT, JR.

Primary Carcinoma of the Lung with Cavity Formation, A. STILLMUNKBSAND J. DE BRUX. Lee processus d’excavations du cancer primitif du poumon, Toulouse mCd 37: 347-355, 1936. A woman eighty-two years of age had a carcinoma of the lung which had formed a large cavity. Otherwise there were no unusual features. No illustrations are included. EDWARDHERBERT, JR. Benign Tumom of the Bronchus, P. G. GERLINGS.Goedaardige bronchusgezwellen. Nederl. tijdschr. v. Geneesk, 80: 5126-5130, 1936. The author reviews the literature, tabulates the reported examples of benign bronchial tumors, and adds a case. A woman thirty-eight years of age, with a three years’ history of hemoptysis, was found by bronchoscopy to have a pedunculated tumor of the left main bronchus. It was removed and proved to be an adenoma. The patient remained symptom-free. Two photomicrographs are included. EDWARDHERBERT, JR. Endothelioma of the Pericudium, J. C. DICK. J. Path. & Bact. 47: 43-46, 1938. A man aged twenty-one died after an illness of seven months with extensive tumor growth in the visceral layer of the pericardium. The growth spread into the mediastinum and root of a lung but there was no tumor in the lung tissue nor in the bronchial tree, which was examined with great care. The tumor cells had an irregularly alveolar arrangement or, more commonly, lined acinar-like spaces. The cells stained like epithelial cells but all the organs which might have contained primary carcinoma were found free from tumor. The likeness of the cellular lining of the more regular acini to the groups of young proliferating pericardial cells found in organizing pericarditis strongly suggested a close genetic relationship, and the growth was diagnosed as a primary THE DIGESTIVE TRACT 623

endothelioma of the pericardium. A photograph of the gross specimen and 6 photomicrographs are included. L. FOULDS

THE DIGESTIVE TRACT

Oerophaged Carcinoma, G. HALLORAN. M. J. Australia 2: 983-987, 1937. Malignant Disease of the Oeeophagu~,J. G. EDWARDS.M. J. Australia 2: 987-989, 1937. Radiational Treatment of Oesophageal Carcinoma, C. DE MONCHAUX. M. J. Australia 2: 989-992, 1937. These three papers discuss the general features of esophageal cancer, its diagnosis, and treatment. Halloran refers to a series of 100 cases but gives no detailed analysis of these.

R~cerousGastritis, F. MOUTIER. La gastrite prbcancbreuse, Paris mbd. 1: 283- 287, 1936. A general discussion is given of the various types of gastritis. It is stated that in general the gastritis associated with ulcer is inflammatory in nature, in old age it is atrophic and represents a simple reduction of all structures, while the gastritis that pre- cedes carcinoma is unequal in distribution, showing areas both of atrophy and of proliferation and increased mucus secretion. It is in these latter areas that the carcinoma ultimately develops in many cases. Clinically these patients present a long history of digestive disturbances and it is extremely difficult to know where the symptoms cease being those of gastritis and become indicative of a malignant tumor. Two drawings are included. EDWARDHERBERT, JR.

Coincidence of Gastric Ulcer and Carcinoma, J. HAAS. Echtes oder unechtes Zusam- mentreffen von Ulcus und Karzinom im Magen? Schweiz. med. Wchnschr. 18: 627-629, 1937. There are several methods of development which can account for the coexistence of gastric ulcer and carcinoma. They may occur as independent lesions. Malignant change in a peptic ulcer is probably a not infrequent complication, but a true peptic ulcer developing in an area of carcinoma is a rare occurrence. Two cases are described illustrating the first and second types of disease. A man of thirty had chronic gastric disturbances of ten years' duration, and a roentgenogram showed a pyloric ulcer. A gastric resection was performed. Histologic examination confirmed the diagnosis and revealed, in addition, a hypertrophic gastritis and an independent colloid cancer of small size 6 to 8 cm. distant from the ulcer. The later history is not mentioned. The second patient, a woman of forty-three, also had a pyloric ulcer and a gastric resection. She died seven years later of carcinoma metastases in both ovaries, the skeletal system, and in the dura. It is assumed that the metastases were from a beginning carcinoma in the ulcer. Atypical epithelial proliferation had been found, but a definite malignant change was not surmised. The gastric contents of both patients at the time of operation contained free hydrochloric acid. A photomicrograph is included. MILTONJ. EISEN

11 There a Connection between Pernicious Anemia and Gastric Cancer? D. VAN DEB SANDE. Bestaat er verband tusschen pernicieuse anaemie en maagkanker? Ne- derl. tijdschr. v. Geneesk. 80: 4774-4781, 1936. On the basis of statistical evidence the tentative conclusion is drawn, that there seems to be a connection between pernicious anemia and carcinoma of the stomach, since they appear with or following each other more frequently than they do in the general population. The most probable explanation is that they have a common etio- logic factor. There are no illustrations. EDWARDHERBERT, JR. 624 ABSTRACTS

Coume and Prognosie of Sarcoma of the Stomach, K. ECGER. Zur Kenntnis des Verlaufes und der Prognose des Magensarkoms, Schweiz. med. Wchnschr. 18: 185-187, 1937. A report of 3 cases of sarcoma of the stomach. Clinically the condition, although of relatively benign character in 2 patients, could not be differentiated from carcinoma. A round-cell sarcoma and a lymphosarcoma were found in women of thirty-seven and sixty-seven years of age respectively. The tumors were situated on the lesser curvature and symptoms referable to the stomach had been present for five and two years. There were no metastases. Gastric resection was performed and no recurrence was noted after periods of eight and four and a half years. The third case, in a man of sixty-seven years, ended fatally. The patient had an inoperable myoblastic sarcoma on the lesser curvature which had given rise to peritoneal and hepatic metastases. There are no illustrations. MILTONJ. EISEN

Results of Surgical Treatment of Cancer, R. NICOLE. Aus dem Nachsorgedienst fur der Krebsoperierten, Schweiz. med. Wchnschr. 18: 646-647, 1937. An analysis of the statistics on operative treatment of cancer of the stomach. A radical resection was possible in 123 (24.5 per cent) of 502 cases, and the operative mortality was 26 (5.2 per cent). There was a five-year cure in 25.3 per cent of these patients and a ten-year cure in 13 per cent. [On comparing the number of cures with the total cases it may be observed that the actual percentage of cured cases is only 3 to 4 per cent.] MILTON J. EISEN

Solitary Neuroilbroma of the Stomach, G. LEVY. Een Geval van een enkelvoudig neurofibroom van den Maagwand, Nederl. tijdschr. v. Geneesk. 80: 2601-2603, 1936. A woman thirty-seven years of age who complained of gastric pain and vomiting was found on x-ray examination to have a lesion of the stomach suggestive of,a carcinoma. At operation a circumscribed tumor of the posterior wall of the stomach was removed. The patient became symptom-free after the operation. Microscopic examination showed the tumor to be a benign neurofibroma, although there was no evidence of generalized von Recklinghausen’s disease. Only two similar cases were found in the literature. There are no illustrations. Several references are given, EDWARDHERBERT, JR.

Sarcoma of the Ileum, H. SAKANASHI.ober einen kasuistischen Fall von Ileum- sarkom, Gann 31: 96-1 10, 1937. A woman of thirty years had a painful mass in the right lower quadrant of the abdomen, and an exploratory laparotomy revealed this to be an inoperable tumor, measuring 25 X 20 cm., in the region of the lower ileum. Roentgen therapy had no influence on the growth. Diffuse peritonitis produced a fatal termination. At necropsy an ulcerative process was found in the lower ileum with the base formed by the tumor. There were metastases in the peripancreatic lymph nodes. Histologically the tumor appeared to be a reticulum-cell sarcoma originating in the lymph follicles of the intestinal wall. Roentgenograms, a photograph of the tumor, and photomicrographs are included. MILTON J. EISEN

Carcinoid of the Lower Ileum, F. MERKE. Das Karzinoid der untersten Ileumschlinge, Schweiz. med. Wchnschr. 18: 639-641, 1937. A diagnosis of acute appendicitis was made in a man of sixty-three. Laparotomy revealed an intestinal obstruction caused by two polypoid masses, 3 and 2 cm. in diameter, in the ileum immediately proximal to the ileocecal valve. The regional lymph nodes were enlarged. Because of the patient’s age the operation was limited to an ileocolic anastomosis. Following a symptom-free period of five years, death occurred from erysipelas complicated by pneumonia. At necropsy the local intestinal THE DIGESTIVE TRACT 625 condition was found to be unchanged. The mass proved to be a carcinoid with metastases in the neighboring nodes. An illustration of the growth is included. MILTONJ. EISEN M.lipnmt Change in a Ganglioneuro5bromatosis of the Mesentery and Intestine, A. JENTZER AND H. FATZER.Ein Fall von Ganglioneurofibromatose des Mesenter- iums und Darms mit maligner Umwandlung, Schweiz. med. Wchnschr. 18: 569-571, 1937. A boy of seventeen had a slowly growing symptomless abdominal mass for three years. Following local trauma the swelling rapidly increased in size and became painful. An abdominal tap yielded 2500 C.C. brown fluid with a positive reaction for blood. A laparotomy was performed and a partially cystic mass, 19.0 X 14.5 x 15.0 cm., situated in the mesentery and involving the lower ileum, was removed. The patient died five days later. The mesentetic portion of the tumor had the histological structure of a neurinoma. The growth infiltrated the intestinal wall, which appeared thickened. Ganglion cells were numerous in this portion. Histologically the tumor was a type of plexiform ganglioneurofibroma, possibly originating in the plexus of Meissner. Its tendency to infiltrate speaks for malignant change, but there were no metastases. A photograph of the tumor and photomicrographs are included. MILTONJ. EISEN

Carcinoma of Meckel’s Diverticulum. Report of a Case, J. M. WEIR. Arch. Path. 24; 791-793, 1937. A case of carcinoma arising in Meckel’s diverticulum is recorded. The author states that five cases have been previously recorded and gives references to three of these. No illustrations are included. Cardnoid Tumour of the Appendix Causing Acute Appendicitis, T. HAMILTON.M. J. Australia 2: 1086-1087, 1937. Operation on a patient with symptoms of acute appendicitis not only confirmed that diagnosis but revealed a carcinoid tumor which had led to appendicular obstruction. Early Diagnosis of Tumors of the Sigmoid, G. L. DECOPPET. Die Frtihdiagnose der Tumoren des untern S romanum, Schweiz. med. Wchnschr. 18: 241-244, 1937. This paper contains a general description of tumors of the sigmoid and a reference to 30 patients with carcinoma on whom operation was performed. Radical resection was possible in only 13 of the cases, or 40 per cent. In the remaining group the growth was too extensive to permit more than a colostomy. Better diagnosis-many inoperable cases had been diagnosed incorrectly when the condition was in a less advanced stage and consequently earlier operative intervention are stressed as means to a cure. De- tailed results of the treatment are not given and there are no illustrations. MILTONJ. EISEN Carcinoma of the Upper Part of the Sigmoid, F. BERTRAND.Cancer de la portion haute de I’anse sigmoIde, Toulouse m6d. 37: 327-331, 1936. This is a single case report with discussion of extraperitoneal resection with end-to- end anastomosis. There are no illustrations. EDWARDHERBERT, JR.

Carcinoma of the Iliac Colon, J. P. TOURNEUXAND M. CAHUZAC.Cancer du c8lon ilio-pelvien, Toulouse m6d. 37: 588-590, 1936. This is a report of a single case without unusual features. EDWARDHERBERT, JR. Practical considerations in the Treatment of Colonic Carcinoma, C. F. DIXDN. Wis- consin M. J. 36: 355358, 1937. The author concludes some general remarks on carcinoma of the colon with the statement that there seems to be ample justification for optimism as to its curability. The prognosis is most favorable if the lesion is situated in the right half of the colon and 626 ABSTRACTS poorest if it is in the left half. A study of 753 cases of carcinoma of the colon was made, of which 187 were in the right half: 108 or 57.7 per cent of these patients were alive five years or more after operation. In 566 cases of carcinoma the lesion was situated in the left half of the colon, including the rectum; 270 or 47.7 per cent of the patients were alive five years after operation.

Surgery of Cancer of the Rectum. IS the Disuse of the Kraske Traneeacral Method in France Justifiable? P. JOURDAN.Rbflexions sur la chirurgie du cancer rectal; I’oubli dans lequel est tenue, en France, la voie trans-sacrbe, de Kraske, est-il legitime? Paris mbd. 1: 253-259, 1936. In France rectal carcinomas are resected routinely by the perineal or abdomino- perineal route. In this article a plea is made for Kraske’s transsacral approach for tumors located in the ampulla. This is the routine method in Vienna, consisting in a resection of the coccyx and the lower third of the sacrum with consequent resection of the rectum; the anal sphincter is conserved so that the normal intestinal function can be re-established. Not only is the end-result much more agreeable to the patient, but the mortality is lower, there are fewer complications, and lasting cures are more frequent. The article is not illustrated. EDWARDHERBERT, JR.

Treatment of Cancer of the Rectum by Electrocoagulation, J. A. JOHNSON. Wisconsin M. J. 36: 430-434, 1937. The author advocates electrocoagulation for rectal carcinoma in patients who are inoperable because of advanced age, associated lesions, or the advanced stage of the growth itself. A carcinoma located in the extraperitoneal portion of the rectum that has not penetrated into surrounding structures can be completely destroyed by this means. If the growth is located in the intraperitoneal area and is extensive, electrocoagulation can be considered a palliative treatment only. It can often take the place of colostomy if there is impending obstruction, and will relieve bleeding and offensive discharges from the rectum. A series of 10 cases is recorded in which 21 operations were done. The patients ranged in age from sixty-two to eighty-five years, the average being seventy-one. There was no operative mortality. Four of the series died as a result of distant metastasis or extensive local recurrence. In all of these, however, the lesion was in the intraperitoneal portion of the bowel and was so extensive when first seen that a complete removal could not be done. Five patients are living and well without any recurrence. One has an inoperable mass in the pelvis.

THE PANCREAS

Malignancy of the Pancreas, E. M. ELLISON. Med. Rec. 1%: 400-401, 1937. A report of a case of carcinoma of the head of the pancreas discovered at autopsy. There are no illustrations and no histologic details are given.

THE BILIARY TRACT

Case of Primary Carcinoma of thi Liver, E. P. SNIJDERS.Een geval van primairen leverkanker, Nederl, tijdschr. v. Geneesk. 80: 1329-1334, 1936. This is a clinical lecture illustrated by the report of a case of primary liver-cell carcinoma in a Javanese man thirty years of age. The diagnosis was proved at autopsy. Six photographs and four photomicrographs are included. [The frequency of this diaease in the Javanese is one of the most interesting examples‘of racial peculi- arities in the incidence of malignant neoplasms. See Bonne (Am. J. Cancer 25: 811, 1935) and references there cited.] EDWARDHERBERT, JR. THE SUPRARENAL GLANDS 627

THE SPLEEN Splenomae (Hamartomae) of the Spleen, E. MORDASINI.ober Splenome (Hamartome) der Milz, Virchow's Arch. f. path. Anat. 298: 594-615, 1937. A short summary is given of the cases of splenoma reported in the literature, and 6 additional cases are recorded. In 5 of these the splenic tumor was an incidental finding at autopsy. The other case was unique in many respects. A man twenty-three years of age suffered from repeated attacks of extremely severe left abdominal pain. An exploratory laparotomy was performed and a splenectomy was done. Attached to the lower pole of the spleen by a relatively thin pedicle was a tumor 11 cm. in diameter. This is the largest splenoma on record, and the only one which was pedunculated, as well as the only one giving definite clinical symptoms. The pain is explained on the basis of increased tension of the splenic capsule. After operation the patient was symptom-free. Of the author's series of 6 cases, 4 were in men, 2 in women, and the ages ranged from twenty-three to eighty-four years. In one case there were multiple nodules, in all the others single ones. In no case was the tumor encapsulated, and in all but one there were definite signs of compression of the surrounding tissue. In every instance microscopic examination showed the tumor to be composed of splenic pulp. Trabeculae were present in only 2 cases, and were narrow and few in number. Lymph follicles were present in only one case, and then in diminished size and numbers. These tumors are rare,.only 4 cases having been found in a series of 10,000 autopsies. They can be classed as true hamartomas in the sense that they represent a dispro- portionate growth of one type of tissue of the normal spleen, namely the splenic pulp. A follicular type of splenoma has been described, but was not represented in this series. Secondary changes may occur as a result of congestion, hemorrhage with hemosiderin deposition, and involutional processes with a marked increase in the connective tissue. Usually the tumor is situated just beneath the capsule, but except for this there appears to be no site of predilection. Splenomas participate in the functions of the spleen itself and share its pathological changes. Usually they do not attain a large size, give no symptoms, and cause no changes in the blood picture; they have never been known to become malignant. Two photographs, three photomicrographs, and a bibliography are included. EDWARDHERBERT, JR.

ThE SUPRARENAL GLANDS Paroxyemal Hypertension and Other Clinical Manifestations Associated with Benign Chromafan CellTumors (Phaeochromocytomata), J. E. HOWARDAND W.H. BARKER. Bull. Johns Hopkins Hosp. 61 : 371410, 1937. An instance of medullary chromaffin tumor of the adrenal with paroxysmal hypertension is reported and 17 cases from the literature are abstracted. Eight patients were females and 10 males and the ages ranged from sixteen to sixty-nine. The hypertensive attacks usually increased in frequency as the disease progressed. Their duration varied, but averaged one or two hours, and they were especially frequent in the early morning. There was no definite predisposing cause for the attacks, but in some instances they could be induced by the assumption of certain positions, and exertion and emotional stress were regarded by some patients as precipitating factors. In 11 of the cases the general health was good. In the presence of persistent hypertension the findings in the renal arteries, the cardiac manifestations, and the results of urinalysis were the same as in essential hypertension. The paroxysmal attacks were usually accompanied by pain and 10 of the patients complained of headache, while nausea or vomiting occurred in 18. As the blood pressure rises the patient usually becomes cold, the skin is pale or mottled, and palpitation occurs. If the attack is prolonged, signs of cardiac incom- petence may appear. Sweating during or immediately following an attack is common. Medication has not been found to influence either the frequency or the severity of the attacks. 628 ABSTRACTS

In 8 of the cases there was a palpable abdominal mass. In 4 of 7 instances in which pyelograms were made the tumor was demonstrable. Eleven of the 18 patients were operated upon and there were 2 operative deaths. In all 9 patients surviving there was complete alleviation of symptoms. Three were known to be well three, six, and eight years. Eight of the series, including the authors’ patient, came to autopsy. In all except one of these persistent hypertension had been present during life. The authors do not include in this series the case recorded by Van Goidsenhoven and Appelmans (Bull. Acad. roy. de mbd. de Belgique 14: 672, 1934. Abst. in Am. J. Cancer 26: 665, 1936) but mention this in an addendum. A bibliography is appended. There are no itlustratione. Supruanal Tumor with Paroxymnal Hypertension, Case Report, V. L. EVANS.J. Lab. & Clin. Med. 22: 1117-1120, 1937. A girl of twelve years complained of attacks of severe pectoral pain, with a purplish discoloration of the hands and feet and profuse sweating. During the attacks the blood pressure rose to as high as 285 systolic and 230 diastolic, the heart rate became rapid, the pupils were dilated, and the retinal arterioles narrowed so as to be scarcely visible. Operative exploration of the suprarenal glands was planned but before this could be done death occurred in shock folhwing a severe attack. At autopsy a medullary tumor of the left suprarenal gland was found, a pheochromocytoma. A photograph of the tumor is included but no photomicrograph. References are appended.

THE FEMALE GENITAL TRACT Socondug Infections in Cancer of the Cervix: Their Importance from the Point of View of Prognosis and Radiotherapy, P. DESAIVE.Les infections secondaires du cancer cervico-utbrin; leur importance au point de vue du pronostic et du traitement par les radiations, Paris mbd, 1: 242-252, 1936. In a group of 245 cases of carcinoma of the cervix treated by radiotherapy there were 34 with complications of an infectious nature. In 20 cases this was a cervicitis or metri- tis, in 3 cases pyometra, in 4 acute infection of the adnexa, in 4 a pelvic peritonitis, and in 3 a thrombophlebitis. Of the 34 patients 8 died within four months, and of the other 26 only 8 lived more than a year. A detailed discussion is given of the bacterio- logical, clinical, and therapeutic aspects of these complications. There are no illustrations. A bibliography is appended. EDWARDHERBERT, JR. Involvement of the Upper Pat of the Urinary Tract Associated with Uterine and Ovarian Tumors, H. L. MORRISAND V. R. JURACSEK. J. Urol. 37: 582-587, 1937. A study was made of the upper urinary tract in 42 women with tumors arising from the uterus or adnexa. In one case there had been evidences of a tumor for fifteen years, but in most cases the duration was one to three years. Fifty-five per cent of the patients had symptoms referable to the bladder and 21 per cent symptoms referable to the upper part of the urinary tract. In 44.2 of the patients with urinary tract symptoms ureteral dilatation was demonstrable and in 37 per cent dilatation of the renal pelves. Only 50 per cent of the patients in whom hydronephrosis was demonstrated had renal symptoms. The literature is reviewed and references are appended. Adanomas of the Body of the Uterus, N. C. LAPEYRE. A propos des adbnomes du corps de I’ut6rus, Paris mbd. 1: 36-42, 1936. Two cases are reported in women fifty-six and sixty years of age, both of whom had as a presenting symptom irregular vaginal bleeding. In each case a total hysterectomy was performed. Pathological studies showed the lesion in one patient .to be a circumscribed benign adenoma, and in the other a malignant adenoma believed to have resulted from malignant change in a benign tumor. Uterine adenomas are rare and can be diagnosed only by curettage, The treatment is hysterectomy since they tend to recur THE GENITO-URINARY TRACT 629 after curettage and also are likely to become malignant. A roentgenogram and a photomicrograph are included. EDWARDHERBERT, JR.

Diagnosis and Treatment of Intra-uterine Polyps, P. MOCQUOTAND R. PALMER. Diagnostic et traitement des polypes intracavitaires de I'utbrus, Paris mbd. 2: 462- 467, 1936. This is a general discussion of intra-uterine polyps, especially urging lipiodol injection 'and hysteroscopy as aids in diagnosis. It contains no new material, but several drawings are included. EDWARDHERBERT, JR.

Myomectorny in the Treatment of Uterine Fibroids, G. COTTE. Quelle place donner aux myomectomies dans le traitement des myomes utbrins? Paris mbd. 2: 511-516, 1935. A general discussion is given and the opinion is expressed that whenever possible myomectomy should be performed for uterine fibroids in order to avoid the psychic trauma of an artificial menopause following hysterectomy. The article contains no new material but 5 photographs are included. EDWARDHERBERT, JR.

Terntoma of the Ovary in a Child, J.. J. SEARBY.M. J. Australia 2: 922-923, 1937. Report of an ovarian teratoma in a girl of twelve. The tumor was successfully removed and examination showed derivatives of all three embryonic layers. In spite of its fairly large size the growth had caused no symptoms other than abdominal enlargement.

Ovuirn Demoid Cyst with Twisted Pedide Simulating Renal Colic, E. DELICTISCHAND S. W.VERNICK. M. Rec. 145: 205-206, 1937. Report of a case.

Chodoangloflbroma of the Placenta, B. W. REAMY. J. Lab. & Clin. Med. 22: 899-902, 1937. A case is recorded of chorio-angioma of the placenta discovered following a normal delivery. The tumor occurred in the form of several solid nodules separated from the placenta proper by a thick coat of compressed syncytium or Langhans cells. It was composed of fibrous tissue containing nests of capillaries lined with a single layer of epithelium. These benign placental tumors were described by Siddall, who collected 131 cases (Am. J. Obst. & Gynec. 8: 430, 554, 1924). Photomicrographs are reproduced.

THE GENITO-URINARY TRACT Malignant Tumors of the Kidney in Childhood, R. JEMMA.Clinique de cancer du rein chez I'enfant, Schweiz. med. Wchnschr. 18: 1089-1091, 1937. Malignant tumors of the kidney are reported as relatively more frequent in children between one and ten years than at other ages. They constitute 30 per cent of all neoplasms occurring during this period of life. The author describes the symptomatology commonly associated with kidney tumors, but details as to the pathology, treatment, and course in the 19 cases which he observed are not included. MILTONJ. EISEN

A Case of Abdominal Tumor, F. TANER.A propos d'un cas de tumeur abdominale, J. d'urol. 43: 255-258, 1937. This is a report of an extremely large hypernephroma of the right kidney in a girl fourteen years of age. The diagnosis was verified at autopsy. A photograph and two roentgenograms are included. EDWARDHERBERT, JR. 630 ABSTRACTS

Radiography of the Urinary Tract in Solid Tumom of the Kidney, G. JASIENSKI. De la radiographie des voies urinaires dans les tumeurs solides du rein, J. d'urol. 42: 543- 548, 1936. This is a general discussion without new material. It is not illustrated. EDWARDHERBERT, JR.

Irradiation of Malignant Renal Neoplasms, with Especial Reference to the Effects of Irradiation on the Acquired Single Kidney, A. D. MUNGER. J. Urol. 37: 680-691, 1937. The author regards preo erative irradiation as a beneficial adjunct in the treatment of renal tumors. He recorcf s 6 cases of which 2 received postoperative irradiation only and the remainder both preoperative and postoperative therapy. The total dosage was 2100 to 3000 I per skin area. While the treatment seems to have an irritating effect on the remaining normal kidney this effect disappears on cessation of treatment. If the remaining kidney is already damaged by nephritis, a very marked latent depressant effect is observed and may prove fatal.

Tumors of the Renal Pelvir, A. M. GASPARIAN.Tumcurs du bassinet, J. d'urol. 43: 130-140, 1937. Among 950 operations on the kidney performed at the First Medical Institute in Moscow, 11 tumors of the kidney pelvis were found. Eight patients were men and 3 were women. The ages were from twenty-four to fifty-eight years. In only one instance were there associated renal calculi. In 2 cases the tumors were papillomas and the patients were well five years later. There were 4 papillary carcinomas, and of these patients one was well after tbree years, another after three months, one died sixteen days after operation, and the outcome in the fourth is unknown. There was one hypernephroma and this patient was well after three years. In the remaining 4 cases the histology of the tumor is not known. In this last group one patient died a year after operation, 2 were well seven years and one year respectively, and the fourth was untraced. There are no illusttations. EDWARDHERBERT, JR.

Non-papillary Squunous Cell Epithelioma of the Renal Pelvis, J. B. PRIESTLEY.J. Urol. 37: 674-679, 1937. Non-papillary squamous-cell epitheliomas of the renal pelvis are rare. Unlike papillary tumors, they do not metastasize by transplantation into the ureter or bladder, but extend by local invasion into the perirenal tissues and by distant metastasis, often to bone. They are of a higher grade of malignancy than the papillary lesions and the prognosis is more unfavorable. The course is usually short and rapid. The exact diagnosis is seldom made preoperatively. Nephrectomy with removal of the proximal 6 or 7 cm. of ureter is the procedure of choice. A case is recorded. Photomicrographs and roentgenograms are reproduced and there is a bibliography.

Retroperitoneal Perirenal Llpornata, E. A. OCKULYAND F. M. DOUGLASS.J. Urol. 37: 619-630, 1937. Perirenal lipomas involve the normal fatty tissues surrounding the kidney and frequently attain such dimensions that they fill the greater part of the retroperitoneal space. The exact point of origin in the retroperitoneum is frequently problematic. The onset of these tumors is insidious and an accurate preoperative diagnosis is difficult. In unoperated cases coming to autopsy cachexia and compression of the lungs, intestines, or ureters have been given ae the causes of death. Recurrences are not infrequent and many show sarcomatous changes. Two cases are recorded. Both patients were operated on, the fatty mass being removed and the kidney conserved. One patient was alive and well eleven years later. The other died of postoperative shock. Photomicrographs and a bibliography are included. THE GENITO-URINARY TRACT 63 1

Primup Papillary Carcinoma of the Ureter, W. N. TAYLORAND C. A. KUEHN. J. Urol. 37: 504-512, 1937. Two cases are recorded. The first patient was a man of fifty-four who gave a history of several attacks of hematuria associated with frequency of urination. Cystoscopy revealed a conical tumor protruding from the left ureteral orifice. At operation the lower portion of the ureter was found to be involved by an irregularly elongated mass 14 X 3 cm. while a firm papillary tumor protruded from the orifice. A nephro-ureterectomy was done, followed by roentgen therapy. Microscopic examination showed the lower ureteral mass to be a papillomatosis with low-grade malignant changes. The tumor at the orifice was of a similar type but of a higher degree of malignancy. Two years later the patient had had no recurrence of symptoms. The second patient was a seventy-six-year-old woman who complained of hematuria, backache, and attacks of severe colic referable to the left lower quadrant of the abdomen. Attempts at catheterization showed obstruction of the left ureter and ureterograms revealed a filling defect. As in the preceding case, a nephro-ureterectomy was done and a papillary carcinoma of the ureter was found. The patient wag well a year later. Photographs of the gross specimens, photomicrographs, and the roentgenogram showing the filling defect in the second cabe are reproduced. A bibliography is appended.

Tumors of the Bladder, J. M. IRGERAND A. I. MICHELSON. Sur les tumeurs de la vessie, J. d'urol. 41 : 536-545, 1936. A general discussion based on a study of 135 bladder tumors, of which 56 or 41 per cent were malignant. Biopsy alone is not always sufficient for diagnosis, since tumors may appear benign in some areas and malignant in others. The clinical aspects also have to be taken into account. The best method of treatment is electrocoagulation, either transurethral or endovesical. There are no illustrations. EDWARDHERBERT, JR.

Tumors of the Urinary Bladder, J. B. WEARAND P. KUNDBRT.Wisconsin M. J. 36: 165-169, 1937. This is a clinical survey of 100 cases of cancer of the bladder. Fifty-three of these were graded as to degree of malignancy: 9 were of grade I and in this group there were 2 deaths; 9 were of grade 11, with 4 deaths; 22 of grade 111, with 16 deaths; and 13 of grade IV with 13 deaths. The method of treatment varied. Only 17 of the 100 patients could be treated conservatively. Transurethral eIectrocoagulation was done in these and 13 are now alive, 3 for five years or longer. In 34 cases cystostomy and electrocoagulation were done, supplemented by radium in 12. In this group there are 13 survivals, including 1 for more than five years. Seven patients had extraperitoneal resection with 5 deaths and 1 six-year survival; 5 had transperitoneal resection, with 4 deaths; 37 had either a palliative cystostomy or no treatment, and all but one, who was recently treated, have died. The incidence of metastases in 21 autopsies was 52 per cent. A short bibliography is appended. Tumors of the Bladder with Adonomatous Structure, E. CHAUVIN.Tumeurs vdsicales A structure d'addnome, J. d'urol. 42: 521-527, 1936. A man fifty-one years of age developed urinary retention and a large tumor of the bladder was removed which proved to be a fibro-adenoma. These adenomatous bladder tumors are discussed and the conclusion is drawn that they arise from anomalous glands in the bladder wall. Two photomicrographs are included. EDWARDHERBERT, JR. Endometriode of the Bladder, E. G. MARK. J. Urol. 37: 799-807, 1937. Case report, illustrated by photomicrographs. Dingnoris and Treatment of Early Carcinoma of the Prostate, R. S. FERGUSON.J. Urol 37: 776782, 1937. A study of three series of aspiration biopsies of the prostate led the author to the conclusion that the surgeon inexperienced in this technic may expect to obtain tissue in 632 ABSTRACTS two-thirds of his cases, but experience will improve this result. Negative biopsies are valueless. The second part of this paper deals with the radium treatment of early prostatic carcinoma by the implantation of gold seeds according to a technic previously described (Ferguson: Am. J. Cancer 16: 783, 1932). Of 14 patients treated by this method over three years ago, 4 are alive without evidence of active cancer; 10 have died.

Should Proetatic Carcinoma be Treated Surgically? ANDRS. Faut-il operer le cancer de la prostate? J. d'urol, 42: 212-215, 1936. Andre does not believe that any operative procedures should be used in prostatic carcinoma. Total prostatectomy he considers useless, because there are always recurrences or metastases. Transurethral resection he shuns since he adheres to the old belief that cutting into a cancer causes it to grow more rapidly. There are no illustrations. EDWARDHERBERT, JR.

Primary Carcinoma of the Urethra, J. S. LEWIS,JR. Med. Rec. 1%: 17-21, 1937. Seven cases of urethral carcinoma are reported, of which 5 occurred in women and 2 in men. Only one patient had lymph node metastases. Three cases were treated by electrical excision and intraurethral application of radium ; one by surgical excision and desiccation of the base; one by excision with implantation of radon seeds and deep x-ray therapy; one by amputation of the penis with transplantation of the urethra in the perineum, and one by cystostomy with intraurethral application of radium in the posterior urethra followed by deep x-ray therapy. The patient with involved nodes was alive at the time of the report but with widespread metastases. Insufficient time had elapsed to foretell the future in the other cases.

Angioma of the Urethra, P. DOMINICI.Angiomes de I'uretre, J. d'urol. 42: 34-51, 1936. A man twenty-four years of age who had had urethral bleeding at times for fourteen years was found to have an extensive angioma of the urethra. Radium therapy was followed by complete cessation of symptoms. In the literature 18 similar cases were found, 10 in men and 8 in women. A short abstract is given of each case. A drawing and a good bibliography are included. EDWARDHERBERT, JR.

Intersedty with Bilateral Tubular Adenomas of the Testes, I. KR~CKMANN.Inter- sexualitat bei beiderseitigen tubularen Hodenadenomen, Virchow's Arch. f. path. Anat. 298: 619-635, 1937. A pseudohermaphrodite twenty-five years of age had the secondary sexual characteristics and external genitals of a female but no vagina. Following an attempt to con- struct a vagina from a portion of the sigmoid the patient died of peritonitis. At autopsy it was found that there was no uterus. The pelvic organs were represented by a band of muscular tissue which stretched across the pelvis and terminated on either side in the region of the normal ovary where two organs were situated which proved to be atrophic testes containing numerous small tubular adenomas. The histogenesis of these tumors and their relation to sexual characteristics are discussed in the light of this case and six similar ones that were found in the literature. No definite conclusions are reached. There are no illustrations but a bibliography is appended. EDWARDHERBERT, JR.

Interstitial-cell wore of Testia, L. RIGOLETTI. Tumore di cellule interstiziali del testicolo, Arch. per le sc. med. 61: 557-565, 1936. There are few recorded cases of interstitial-cell tumors of the testis and these have not been universally accepted as true tumors. Waldeyer in 1872 admitted the existence of such neoplasms, but called them plexiform angiomata " in conformity with his belief that the interstitial cell was a perithelial element. The reported cases include some with typical hyperplasia of the interstitial tissue (see for example, DUrck: Ver- handl. deutsch. path. Gesellsch. 11 : 130,1907). Among other cases are three apparently THE NERVOUS SYSTE?kt 633 benign tumors in children, associated with precocious physical and sexual development. In only one of these did the hypergenitalism clear with removal of the tumor. A case is here reported in a normally developed, twenty-year-old priest. The tumor was densely encapsulated and on section showed the characteristics common to these tumors: (1) a parenchymatous structure of pale yellow brown color; (2) columns and groups of lightly stained finely granular polyhedral cells of varying sizes with round nuclei and nucleoli: (3) an abundance of fat droplets, lipoid and lipochrome; (4) close association' with sinusoid-like capillaries. [The three photomicrographs ahow a decided resemblance to adrenal tissue.] A bibliography of forty papers is appended. ADOLPHMELTZER

Benign Turnon of the Epididpmis, A. SCALFI.Sui tumori benigni dell'epididimo, Ann. ital. di chir. 15: 81-124, 1936. Tumors of the epididymis are rare, especially benign growths. Fifty-eight cases have been collected and are listed here, of which 18 were benign, including two personal cases. One of these two cases was a lymphangioma, originally presented before the Medical-Surgical Society of Pavia (March 1935). The second, described in detail, was a complex tumor containing four varieties of tissue: hyaline cartilage, stratified epithelium, bone, and a connective-tissuecapsule. It is classified as a " benign teratoma." As a rule, benign neoplasms of the epididymis are clinically silent. They occur most often in men of thirty to fifty years but have been seen as early as fifteen and a8 late as seventy-one. Of the three segments of the epididymis, the tail is most frequently involved, the body least often. Although testicular tumors are more common in un- descended glands, no epididymis tumors have been reported in this group. Testicular neopIa8ms, even when of large size, respect the anatomical integrity of the epididymis, though that structure seems particularly receptive to the encroachment of inflammatory processes. The mediastinum testis is believed to act as a barrier to the extension of tumors into the epididymis. The author decries the confusion existing in the literature concerning the classification of these tumors. Two chief classifications exist. The simplest is that of Hinman and Gibson (Arch. Surg. 8: 100, 1924) based on clinical criteria, which classifies tumors as benign or malignant and includes 3 types in each group: epithelial, mesoblastic, and heterologous (teratoma etc.). Rubaschow's classification based on hietopathological criteria is dismissed as complicated and slightly fanciful (Ztschr. f. Urol. 20: 290, 1926). The author presents a classification based on " histopathogenetic " criteria which is open to the same criticism. All the reported benign tumors of the epididymis are reviewed; the theories as to their origin and the criteria for their diagnosis are discussed. The types include lymphangioma, benign teratoma, angioma, lipoma, and adenomyofibroma. The largest group, eight, contains the leiomyomas, fibromas, and fibromyomas. The author warns that many of these may well be pseudo-tumors of inflammatory origin. Thirteen photomicrographs are included and there is a bibliography of 53 papers. ADOLPH MELTZER THE NERVOUS SYSTEM

Cerebral Edema and Cerebral Swelling in Brain Tumors, L. JABTJREK. Hirntidem und Hirnschwellung bei Hirngeschwlilsten, Arch. f. Psychiat. 104: 518-547, 1936. A rather long rambling rediscussion of the subject of edema of the brain. The writer's original paper on the subject was published in Neur. polska 15: 103-217, 1933. Anton makes a sharp distinction between cerebral edema and cerebral swelling. So does Reichardt. The writer believes that the two have many points in common. In addition to a mention of the original 18 case reports presented, there are two further case reports. The discussion of edema and swelling of the brain in general reflects the generally known facts. The distinguishing points between them remain obscure. The writer 634 ABSTRACTS

admits, on page 533, that the only term used in the Anglo-Saxon literature to cover the whole subject is “ edema ” [which is probably adequate]. EDWINM. DEERY

The System of Tissue Spaces in the Cerebrum and It8 Rble in the Dissemination of Different Pathologic Prdcesees (Edema, Hemorrhages, Ab8ce88e8, Tumors, and Diseases Causing Demodullation), L. JABUREK. Ueber das GewebslUckensystem des Grosshirns und seine Bedeutung ftir die Ausbreitung verschiedener pathologischer Prozesse (odeme, Blutungen, Abscesse, Geschwtilste und Entmarkungskrank- heiten), Arch. f. Psychiat. 105: 121-161, 1936. That portion of this histopathological study dealing with brain tumors is confined to a section of the paper [pp. 143-1471. A melanosarcoma, two gliomas, and a metastatic tumor were studied. The writer believes that since a pathological process tends to spread in the direction of the larger tissue spaces, the latter to a large extent determine the advance of the tumor. EDWINM. DEERY

Cholesterol Content of the Cerebrospinal Fluid, M. BARTH. Untersuchungen Uber den Cholesteringehalt dea Liquors, Arch. f. Psychiat. 105: 191-225, 1936. A tabulation of the cholesterol content of the cerebrospinal fluid in a series of neuro- logical cases. The tumor cases studied included a glioma, 5 meningiomas, 6 metastatic tumors, 4 hemangiomas, and 7 miscellaneous tumors including pituitary adenomas. Definite conclusions are not drawn from the observations made. EDWNM. DEERY

Treatment of Intradal Tumors, H. CAIRNS. Ergebnisse der Behandlung intra- kranieller Tumoren, Schweiz. med. Wchnschr. 18: 1037-1043, 1937. This paper gives a general discussion of the treatment of intracranial neoplasms. It is estimated that approximately 50 per cent of all cerebral tumors are amenable to some form of operative intervention, but that postoperative fatalities vary annually from 15 to 28 per cent. Surgery is practically impossible in intramedullary or intrapontine tumors, and when attempted usually proves fatal. An intrapontine neoplasm may react favorably to radiation as demonstrated by a case cited. A diagnosis of tumor in this location was made clinically in a boy of four, and x-ray treatment produced an improvement that at the time of writing had lasted for five years. Extracerebral tumors in the posterior fossa may be removed surgically, but care must be exercised not to injure the facial nerve. In such cases a portion of the cerebellum may of necessity be removed, leaving but few residual signs to indicate loss of this portion of the brain. Similarly, careful excision of non-malignant cerebellar tumors is often possible. The treatment of mid-brain tumors is extremely difficult. Subtemporal decompression and radiation gave an encouraging result in a patient with a pineal neoplasm diagnosed clinically and roentgenographically. Details of operative technic and several illustrations are included. MILTONJ. EISEN

A Study of Oliomas: I. Thqir Growth in Relation to the White and Gray Matter; II. Their Relation to Ganglion Cells, H. J. SCHERER.Etude sur lee gliomes: I. Crois- sance des gliomes dans 1qurs rapports avec lee substances blanches et grises du cerveau ; I I. Comportement des different8 gliomes vis-a-vis des cellules ganglionnaires, Bull. de I’Assoc. franc. p. 1’6tude du cancer 25: 451-469, 470-493, 1936. In these two papers the author describes the histologic features of gliomas, though he does not state the number of cases on which his observations were made. Gliomas with a vaned type of growth and different cellular constitution have a mode of extension which depends, for the most part, on the boundaries between the white and gray matter. Frequently, gliomas are limited to the white matter, stopping short of the cortex. Jn many tumors this limitation persists for a long time and the cortex is not involved by the glial neoplasm until necrosis or structural changes occur at the periphery of the tumor. More rarely the litbitation is only transitory. In a certain number of cases the tumor does not extend beyond the internal arciform fibers. On the other hand, THE NERVOUS SYSTEM 63 5 a growth may occur which fills the entire thickness of the cortex, with sharp arrest at the boundary between the cortex and white substance. In masses of gray matter, such as the striatum, the tumor may involve gray matter alone, sparing the myelin fibers. Finally it may be limited to certain structures within the cortex or to the arciform fibers in the white matter. These particular modes of development are not easily understood. Mechanical factors alone are not a sufficient explanation. The normal tissue structures play a r61e in the methods of growth and extension of gliomas. In the second installment of this paper Scherer describes the reaction of ganglion cells to gliomas. Sometimes the ganglion cells are conserved in the midst of a sparsely infiltrated area: sometimes they are injured by contact with the blastomatous tissue. In the latter case, the nerve cells may eventually disappear without participation of the tumor elements. This may be observed in the center of the tumor as well as at the periphery. In other cases the tumor cells participate actively in the disintegration of the ganglionic elements by what the author terms " blastomatous neuronophagia." This may appear only after the ganglion cells are already surrounded by tumor cells (delayed neuronophagia). More frequently it constitutes the first sign of invasion of the gray matter (early neuronophagia). Neuronophagia may be briefly described as an encirclement and finally a replacement of the pre-existing ganglion cell by glial cells of a blastomatous type. A simple accumulation of glial elements around a ganglion cell without penetration of the latter has been referred to as pseudo-neuronophagia. In general, the perineural invasion is not manifested around isolated nerve cells but occurs usually where there are groups of these cells. When a tumor involves the cortex or other gray matter at different points, its reaction with respect to the ganglion cells is, in most instances, uniform in each region. When differences occur they indicate a modification in the character of the development of the tumor. Morphological differences in the structure of the neuronophagic mass are related to the cellular constitution of the tumor. Photomicrographs and references are included. [The observations on glioma recorded in these and his other papers the author has brought together under the title Structural Development in Gliomas (Am. J. Cancer 34: 333, 1938).] CHARLESA. WALTMAN Cerebral Yedulloblastomn, W. M. HONEYMAN.Am. J. Path. 13: 1003-1014, 1937. The authors conclude from a study of the literature that there may exist in the cerebrum sources of embryonic cells such as those that account for the appearance of medulloblastoma in the cerebellum, and report 2 cases confirming this view. One of the patients was a man of thirty-six, the other a child of three. In the older patient the tumor occupied the entire right occipital lobe and the posterior part of the parietal lobe. In the child almost all of the temporal lobe and the white matter of the frontal, parietal, and occipital lobes on the right side were involved. The tumor invaded the caudate nucleus, putamen, globus pallidus and thalamus, and grew down into the orbital gyri. The diagnosis in each case was made from the general character of the cells, which resembled those of cerebellar medulloblastomas of primitive type. The clinical course was also comparable to that of medulloblastomas of the cerebellum. A bibliography is appended and there are four photomicrographs.

Removal of a Parietal Astrocytomo, G. PHILLIPS. M. J. Australia 2: 439-442, 1937. A woman of twenty-seven had occasional convulsions over a period of six years, with loss of consciousness and subsequent headache. Examination showed, among other findings, complete loss of passive position and passive movement sense in the terminal phalanges of the left hand with loss of tactile localization and disturbance of tactile discrimination in this hand. Since these and other forms of deep sensibility are believed to be controlled by the parietal lobe, a diagnosis of a right parietal tumor was made, and this was confirmed at operation. The tumor was an astrocytoma. In the course of its extirpation the major portion of the lobe was removed. Three weeks later the patient was well and free from headache, with almost complete recovery of deep sensibility. 636 ABSTRACTS Veatcicdographic Localizattw of Intrad Tumors. I. Tumora Involving the Po8tdor of the WdVbaMCle md'fhrtuntrr, V. c. JOHNSON AND c.F. LIST. Am. J. Roentgenol. 38: 77-91, 1937. The author considers tumors of the posterior part of the third ventricle and thalamus under two headings. (1) The midline tumors cause deformity of the posterior portion of the ventricle and usually obstruct the anterior portion of the aqueduct without die- placement of these structure5 to either side of the midline. (2) The tumors arising to one side of the midline may produce bizarre and complex ventriculographic signs de- pending upon: (a) unilateral soft tissue protrusion into the posterior portion of the third ventricle: (b) displacement of the posterior portion of the third ventricle away from the tumor side; (c) compression of the body of the lateral ventricle on the affected side and elevation of its floor; (d) downward displacement of the temporal horn on the affected side and partial effacement of the vestibule when the tumor reaches a large size. Cases are reported with drawings and ventriculograms. The ventriculographic technic is described, and three references are appended. Tumors of the Fourth Ventticlo, J. LEBEBOULLET.Lee tumeurs du IVe ventricule. Paris med. 1: 73-83, 161-176, 1936. These two articles give a well organized and comprehensive description of the clinical, pathological, and therapeutic aspects of tumors of the fourth ventricle, but they contain no personal material, being based largely on Bailey and Cushing. Nine photographs, 6 photomicrographs, and several references are included. EDWARDHERBERT, JR.

Tumors of the Fourth VenMale Shulathg Cervical Pott's Disease, VIRENQUE,CBRAUD AND BECQ. Formes pseudo-pottiques des tumeurs de la ligne mbdiane, Toulouse med. 37: 580-581, 1936. Two cases are very briefly reported in which the clinical picture was of Pott's disease: one an astrocytoma the other a cystic arachnoiditis of the fourth ventricle. There are no illustrations. EDWARDHERBERT, JR.

Tumor6 of the Hypophpseal Region, M. BARTELS. Geschwlilste der Hypophysenge- gend, Klin. Monatsbl. f. Augenh. 97: 185-215, 1936. A long discussion of hypophyseal tumors is given, especially as regards the eye syrnp- toms and signs, based on short histories of 17 cases, most of which were diagnosed only by x-ray. Sixteen illustrations are included. EDWARDHERBERT, JR. Diabetes Mellitw with Hypophpsd Tumor, P. HEILMANN.Diabetes mellitus bei Tumor der Hypophyse, Virchow's Arch. f. path. Anat. 298: 616-618, 1937. A woman sixty-four years of age suffered for seven years from diabetes mellitus of constantly increasing severity. At autopsy a tumor of the pituitary was found which involved the entire posterior lobe, the infundibulum, and most of the anterior lobe. Histologically it was a hypophyseal duct tumor. The pancreas showed cloudy swelling of the islands of Langerhass with somewhat increased fibrous tissue. The diabetes was explained as being due to an interruption of the connection between the hypophysis and the vegetative centers of the floor of the third ventricle caused by the tumor formation. There are no illustrations. Several references are given. EDWARDHERBERT, JR. Metmbtic Carcinoma in the Region of the Hypophyrir and Tuber cinereum with Diabetes indpidus, C. I. URECHIA. Cancer mbtaetatique de la region hypophyso- tubbrienne avec diab&e insipide, Paris ma.2: 129-130, 1936. A man fifty-one years of age who six months previously had had an operation for carcinoma of the stomach dpveloped diabetes insipidue and intractable headache. He died shortly afterwards and a metastasis was found which involved the posterior lobe of the hypophysis and the tuber cinereum. There are 2 illustrations. EDWARDHERBERT, JR. THE NERVOUS SYSTEM 637

Rox~~laon Cushing’e Syndrome, F. S. P. VAN BUCHEM. Eenige opmerlringen be- tteffende het syndroom van Cushing, Nederl. tijdschr. v. Geneesk. 80: 4722-4724, 1936. A general discussion is given, without new material, pointing out that at autopsy patients with Cushing’s syndrome often fail to show a basophilic adenoma of the pituitary. The syndrome apparently can be caused by a functional disturbance of the basophilic cells, and it has been shown that in some cases these cells show a change from a granular basophilic to a hyaline cytoplasm, which may indicate an altered phyeio- logical function, rather than a degeneration. There are no illustrations. EDWARDHERBERT, JR.

Cuahing’e Syndrome, M. HOMMES.Het syndroom van Cushing, Nederl. tijdschr. v. Geneesk 80: 3251-3263, 1936. A girl twenty-two years of age died of heart failure and renal insufficiency. She showed clinically all the symptoms of Cushing’s syndrome. At autopsy a fibro- adenoma of the pituitary was found, which was not definitely basophilic in character. None of the other endocrine glands showed any changes. Six illustrations and several references are included. EDWARDHERBERT, JR.

Therapeutic Effect of Menformon in Cushing’s Syndrome, E. LAQUEURAND T. DEELEN. De therapeutische werking van menformon bij de ziekte van Cushing, Nederl. tijdschr. v. Geneesk. 80: 743-748, 1936. A girl twenty-three years of age had a Cushing’s syndromechanged facies and distribution of fat, presence of striae, amenorrhea for two years, hypertension, poly- cythemia, and efevated blood sugar. She had no headache or visual disturbances, however, and changes in the sella turcica could not be demonstrated roentgenographically. Under these conditions surgical intervention was considered unjustifiable and menformon was therefore given in doses of 50,000 and 100,000 units per day, since it was known that this causes a reduction in certain of the activities of the pituitary. A remarkable improvement resulted and all symptoms disappeared except the increased blood pressure, which was unchanged. No mention of this type of therapy could be found in the literature. Three photographs and several references are included. EDWARDHERBERT, JR.

Treatment of Hypophyeeal Stalk Tumors by Evacuation and Irradiation, R. C. CAR- PENTER,G. W. CHAMBERLINAND C. H. FRAZIER.Am. J. Roentgenol. 38: 162- 177, 1937. Three patients with cystic tumors of the hypophyseal stalk were treated by aspiration and irradiation, and one with a solid tumor by decompression and irradiation. All were well and leading normal lives at the time of the report, an average of thirty and a half months after treatment. In the 3 patients with cystic tumors earlier evacuation without irradiation had been followed by prompt recurrence of symptoms. These 4 cases are compared with a series of 8 in which surgery alone was done. Of the latter group, only one was alive and in fair condition thirty months later. The paper is illustrated and concludes with a brief bibliography.

Five Neuro~urgicalPatients, F. VERBEEK. Vijf neuro-chirurgische patienten. Nederl. tidjschr. v. Geneesk. 80: 26562664, 1936. The clinical histories of 5 patients are given, 4 of whom had tumors. These were a parasagittal meningioma, an osteoma of the skull over the frontal lobe, a cystic glioma of the cerebellum, and a tumor of the spinal cord at the level of the seventh thoracic vertebra. All gave typical symptoms, and all were removed successfully by surgery with subsequent disappearance of symptoms. There was nothing unusual in any of the cases. Seventeen illustrations are included. EDWARDHERBERT, JR. 63 8 ABSTRACTS

Case of Epidermoid (Choleeteatoma) Lying under the Scalp and Outside the Peri- durn, N. C. NoRcRoss. Am. J. Roentgenol.'38: 854-858, 1937. A young woman was opergted upon for what was believed to be an intradiploic tumor. The growth was found, however, to be entirely outside the pericranium, in which it appeared to have hollowed Gut a nest for itself. The bone was not involved and was covered by intact periosteuna, The tumor was a typical epidermoid. A brief review of the literature on epidermoids of the central nervous system is included. Roentgenograms and photomicrographs are reproduced and references are added. Roentgenologic Contributions to the Localization of Tumors Affecting the Spinal Cord, J. D. CAMP. Wisconsin M. J. 36: 621-625, 1937. The author has previously reported a series of tumors of the spinal canal in 50 per cent of which osseous changes made localization of the tumor possible (Radiology 22: 295, 1934. Abst. in Am. J. Cancer 22: 226, 1934). . He now records a study of 198 cases of spinal cord lesions verified at operation, in 30 per cent of which bony changes were demonstrable roentgenographically. In a small percentage of cases bony changes are observed where there is no block of the cerebrospinal fluid and its serum protein content is normal. Intramedulluy Tumors of tlie Spinal Cord, I. OLJBNICK. Imtramedullaire gezwellen, Nederl. tijdschr. v. Geneesk. 80: 1335-1342, 1936. Three intramedullary tumors of the spinal cord were removed surgically. The first was an oligodendroglioma weighing 9.2 gm., in the lower thoracic region of a woman thirty-one years old. The second was an astrocytoma weighing 10.5 gm., in the upper cervical portion of the cord in a fifty-nine-year-old man. The third, in a man of twenty- nine, was a solid ependymoma of the lower cervical and upper thoracic region, weighing 19.3 gm. and measuring 10 cm. in length. There were no postoperative complications. The clinical findings are described in detail, but no follow-up is given. Four roentgenograms and three photographs are included. EDWARDHERBERT, JR.

THE BONES

Radiotherapy for Endothelioma of Bone, A. U. DESJARDINS,H. W. MEYERDINCAND E. T. LEDDY. Am. J. Roentgenol. 38: 344-351, 1937. Of 42 patients with microscopically proved bone endothelioma, 11 had the primary tumor removed surgically. Two of these patients are still alive [but the interval since operation is not stated]. Nine died after an average postoperative survival of seventeen months. All but one of the patients-and that one of the two still alive-received postoperative irradiation. Amputation was performed in 4 cases and all these patients died. Twenty-four patients were treated by roentgen rays alone and 3 by roentgen rays and radium. Of the 24 receiving roentgen therapy only, 7 are known to be alive twelve, two, two and a half, seven, five, three, and six years later. One of these patients had a recurrence which regressed following further irradiation. In those who died and for whom the survival period was ascertainable it averaged 23.9 months. Two patients survived four and five years respectively before dying of metastases. A series of 10 cases characteristic clinically of endothelioma but not proved by biopsy is also recorded. All these patients received roentgen therapy alone. Three are living and free from clinical evidence of cancer eleven, two and a half, and two years, respectively, since they were treated. A fourth patient who had two tumors, one of which was metastatic, lived ten years free from any sign of cancer and died after a short illness from what was thought to be pneumonia; neither the primary tumor in the scapula nor the secondary tumor in the ilium had given evidence of renewed activity. The details of treatment are given, and a warning is sounded against excessive irradiation of the rapidly grOwing bones and muscles of young children. LEUKEMIAS, LYMPHOSARCOMA, FOLLICULAR LYMPHOBLASTOMA 639

Metaetatic Pulsating Tumor8 of the Sternum Secondary to Renal Hypernephroma, L. J. ROTHAND H. B. DAVIDSON.J. Urol. 37: 480-489, 1937. A woman of fifty-five had five pulsating masses on the chest, fixed to the sternum. She complained, also, of chills and fever, loss of weight and of appetite, and occasional nausea and vomiting. Examination revealed a mass in the left side of the abdomen and roentgenograms suggested a tumor of the kidney on that side. Roentgen therapy brought about some improvement but a few months later the patient died with symptoms of brain tumor. Autopsy revealed a primary renal-cell carcinoma or hypernephroma of the left kidney with metastases in the lung, liver, and sternum. The brain tumor, however, was not secondary to the renal lesion, as had been believed, but was a primary astrocytoma of the upper parietal right Rolandic area. Pulsating sternal tumors secondary to a malignant thyroid adenoma as well as to hypernephroma have been reported (Crile: Ann. Surg. 103: 199, 1936. Abst. in Am. J. Cancer 28: 196, 1936), but no primary pulsating neoplasms of the sternum are on record. Photomicrographs are included and there is a bibliography. Benign Giant Cell Tumor of a Rib, L. M. HILT. Am. J. Roentgenol. 37: 663-665, 1937. A fifteen-year-old girl had a tumor of the fifth left rib which in the early roentgenograms showed osteolytic manifestations but subsequently had the typical trabeculated appearance of a giant-cell tumor. The response to roentgen therapy was good. A biopsy specimen showed long spindle cells predominating, small bony spicules bordered by osteoblasts, and scattered giant cells, suggesting the possibility of an osteolytic sarcoma. Roentgenograms and a bibliography are included. Oeteitie Fibrosa Cyetica due to Parathyroidism, H. HIRSCH. Am. J. Roentgenol. 38: 457-464, 1937. A case of osteitis fibrosa cystica is reported in which removal of a parathyroid adenoma, was followed by improvement in the clinical picture and the roentgen aspects. Psychoneurotic symptoms developed and the patient was committed to a state hospital, where he died of chronic myocarditis six months after operation. The report is illustrated by roentgenograms.

THE LEUKEMIAS, LYMPHOSARCOMA, FOLLICULAR LYMPHOBLASTOMA, HODGKIN’S DISEASE, RETICULOMA Phagocytic Activity of Circulating Cells in the Various Types of Leukemia, M. M. STRUMIAAND F. BOERNER. Am. J. Path. 13: 335-349, 1937. Studies of the phagocytic activity of the circulating cells in various forms of leukemia were made by different workers on two series of cases at different institutions with different methods. Strumia’s method (J. Lab. & Clin. Med. 21: 930, 1936) was used for the investigation of 7 cases-l of acute and 1 of chronic lymphatic leukemia, 1 of acute and 1 of chronic myelogenous leukemia, 2 of acute hemohistioblastic leukemia, and 1 of glandular fever. Seven cases were studied by Boerner’s technic (Am. J. M. Sc. 189: 22, 1935)-2 cases of acute and 2 of chronic myelogenous leukemia, 1 of chronic lymphatic leukemia, and 2 of allergic conditions. The results in the two series were remarkably uniform. From them the following conclusions are drawn: Lymphocytic cells never show phagocytosis. Undifferentiated oxidase-negative cells (lymphoid hemocytoblasts) likewise show no phagocytic activity. Granulocytic cells and their precursors constantly show active phagocytosis, as follows: undifferentiated oxidase-positive cells (myeloid hemocytoblasts) show slight phagocytic activity in some experiments, doubtful in others. The immature cells (myeloblasts and pro- myelocytes) show a slight but definite and progressive increase in phagocytic activity. It is to be noted that the promyelocyte, which is the first cell of the granulocytic series 640 ABSTRACTS to show the appearance of the specific neutrophilic (or eosinophilic) granulation, is also the first cell showing a definite phagocytic activity in all experiments conducted. The myelocyte, the first cell to possess an entirely mature cytoplasm, namely an acidophilic cytoplasm, with mature (neutrophilic) granulations, shows phagocytic activity greatly increased over the preceding cells. There is further increase in the phagocytic activity with the other cells of granulocytic type, namely metamyelocytes, rod nuclears, and polymorphgnuclears. Eosinophils show phagocytic activity but far less than either neutrophils or monocytes. Basophils show even less phagocytic activity. Monocytic cells (hemohistio- blasts, monoblasts, monocytes) constantly show active phagocytosis. Rieder’s cells show slight but definite phagwytic activity; Tiirck’s cells show none. One plate illustrates this paper.

Saliva Cell Count in Myelogepour Leukemia, K. D. A. ALLENAND L. DICKEY. Am. J. Roentgenol. 38: 57-71, 1937. Studies of 10 cases of myelogenous leukemia, which are recorded here, are believed by the authors to confirm fsaacs’ theory that irradiation decreases the number of circulating leukocytes in thq blood not by destruction but by stimulating them to rapid completion of their life cycle (Isaacs, R.: Am. J. M. Sc. 171: 20, 1926), after which they are excreted through the upper gastro-intestinal and buccal mucosa. Myeloblasts, on the other hand, are influenced toward division, and when these cells dominate the blood picture irradiation is not only useless but probably harmful. As also pointed out by Isaacs (Isaacs and Danielian: Am. J. M. Sc. 174: 70, 1927), the leukocyte count of the saliva bears an inverse relationship to the white blood count, increasing as the latter is decreased by irradiation 80 long as the marrow cells are not exhausted. The saliva count thus becomes a valuable guide to treatment. Persistent failure of the cells in the saliva to increase in numbers ten or more minutes after irradiation suggests exhaustion of tbe marrow hematopoietic myeloblasts and is evidence that a poor response to the current irradiation series is to be expected. A prompt rise in the saliva count, on the other hand, probably indicates a healthier condition of the marrow cells and forecasts a good result from the current series. Charts are included to show the relationship between the blood and saliva counts and blood smears are reproduced. A bibliography is appended.

Acute AlaULemic Wyeloblartic Leukemia, SCHNYDER.Ueber einen Fall von akuter aleukamischer Myeloblastenleuk8mie, Schweiz. med. Wchnschr. 18: 316-317, 1937. An incised infection of the hand in a girl of nineteen healed poorly, and the blood picture showed evidence of qn acute leukemia. The total leukocyte count was 4,970, of which 33 per cent were m eloblasts. Fever, a mouth infection, and enlarged tender cervical nodes developed, an8the white cell count fell to 1,680. A series of transfusions was given, the condition improved, and the leukocytes rose several weeks later to 5,400. There was an occasional myeloblast in the blood smear. The symptoms recurred a month later, and in the course of seven days the white count fell from 1,OOO to 180. Practically all the cells were thought to be of the lymphocytic series. The condition resembled agranulocytosis. Transfusions and nucleic acid therapy were of no avail, and the patient succumbed eeveral days later. Necropsy revealed absence of lymph node enlargement, but charpcteristic myeloid infiltration of the organs was present. There are no illustrations. MILTONJ. EISEN Remarks on the Relation between Leukemia and Myeloma, I. SNAPPER.Bijdrage tot het verband tusschen lebcaemie en myelomen, Nederl. tijdschr. v. Geneesk. 80: 1414-1428, 1936. A woman forty-eight years of age who complained of skeletal pain was found to have a tumor arising from the eernum. It was circumscribed and was microscopically polymorphous, containing erythroblasts, both neutrophilic and eosinophilic leukocytes, plasma cells, multinucleated cells and others with a single nucleus, and baeophilic and eosinophilic cytoplasm. There were large amounts of Bence-Jones protein in the urine, LEUKEMIAS, LYMPHOSARCOMA, FOLLICULAR LYMPHOBLASTOMA 641 as well as a hyperproteinemia and hyperglobulinemia. The blood picture showed a severe hyperchromic anemia, a slight elevation in the number of leukocytes, with a few myelocytes. The spleen was enlarged. At autopsy there was evidence of a myeloid leukemia with myeloid infiltration of the viscera and of the bone marrow, with frequent perforation of the bone cortex and invasion of the surrounding tissues. It is considered that this case was a combination of leukemia and myeloma and 6 similar cases are cited from the literature. There are no illustrations. Numerous references are given. EDWARDHERBERT, JR.

Myeloma and Leulremia, H. T. DEELYAN. Myeloma en leucaemie, Nederl. tijdschr. v. Geneesk. 80: 118-125, 1428-1430, 1936. This is a clinical lecture which discusses these two conditions and argues that myeloma is a true tumor since it is characterized by autonomous growth, while leukemia is characterized by correlative growth and is dependent upon other processes of the organism in tbe same way that normal tissues are. Leukemia, therefore, is not a true tumor but represents simply intensified growth of a certain cell type. Two photomicrographs are included. EDWARDHERBERT, JR.

Lymphosarcoma of the Parotid Gland Cured by Operation, G. SIDAHARA.Ein operativ geheilter Fall von Lymphosarkom der Parotis, Gann 31 : 41-49, 1937. A localized lymphosarcoma of the parotid gland in a man of sixty-seven was removed surgically. The growth measured 5.0 X 3.5 X 4.0 cm. and had been present for six months. Postoperative radiation was used and the tumor had not recurred after a further period of six months. Photographs of the patient and the extirpated tumor, photomicrographs, and a review of the 60 cases of sarcoma of the parotid reported in the literature are included. MILTONJ. EISEN

Folliculu Lymphoblastoma, with Brief Review of Literature, H. M. EWINGAND M. J. FEIN. J. Lab. & Clin. Med. 22: 807-814, 1937. A further instance is recorded of follicular lymphoblastoma first described by Brill, Baehr, and Rosenthal (J. A. M. A. 84: 668, 1925). The patient was a woman of sixty- seven with swelling of the left side of the neck and along the anterior edge of the left axilla. The salient characteristics of the case are recorded as follows: (1) lymph- adenopathy due to hyperplasia of the germinal centers of the lymph follicles; (2) splen- omegaly due chiefly to enormous enlargement of malpighian bodies, the weight of the spleen increasing up to 1,800 gm.; (3) absence of abnormal cells in the blood; (4) absence of anemia or cachexia; (5) tendency to development of serous effusions in the pleural and peritoneal cavities due to pressure of mediastinal or abdominal lymph nodes upon venous or lymph vessels; (6) absence of involvement of tonsils and lymphatic apparatus of the gastro-intestinal tract; (7) tendency to lymphatic infiltration in lacrimal gland resulting in unilateral exophthalmos. Aside from the absence of anemia and cachexia, the chief differential feature distinguishing the condition from lymphosarcoma is its origin multicentrically throughout the body in the lymph follicles, whereas lymphosarcoma arises monocentrically and spreads by lymphatic extension. Treatment by roentgen rays, with iron and arsenic by mouth, was followed by improvement from the clinical point of view. The authors regard the condition as probably arising from a single cell, a lymphoblast. Photomicrographs of the excised nodes are reproduced and references are appended.

Treatment of Lymphogranulomatosis, W. BAENSCH.Unsere Erfahrungen in der Behandlung der Lymphogranulomatose, Strahlentherapie 56: 541-547, 1936. From !925 to 1930 there were treated in the Roentgen Institute at the Surgical Clinic of the University of Leipzig 23 cases of lymphogranulomatosis, while 55 cases received treatment between 1931 and 1936. The author believes that the larger number of cases in the later period is due not alone to improvement in diagnosis, but also to a 642 ABSTRACTS greater frequency of the disease. As the increase is particularly pronounced in aged people, he sees in this condition a parallel to tuberculosis, and a further confirmation of Sternberg’s theory that lymphogranulomatosis is a special form of that disease. The frequent occurrence of bone lesions, especially in the spinal column, is pointed out. The most effective treatment is roentgen therapy. The smaller the initial dose the longer the effectiveness of the treatment. A single focal dose of about 20 per cent of the skin erythema dose, applied with high filtration, followed by climatotherapy, is the method of choice in the first stage. As in tuberculosis, mountain air or exposure to sunlight at the seashore gives good results; at least the first stage of the disease is prolonged. In the second stage-recurrence with slight temperaturehigher x-ray doses are required. As there is usually a decrease in the size of the affected lymph nodes with a fall of temperature between the fourth and sixth day after irradiation, about eight days should be allowed before another treatment. Climatotherapy in fever-free intervals was often effective in this stage. Prontosil has been tried but with as yet no definite results. Blood transfusions also have to be considered. In the third or most advanced stage the author irradiates the spinal column also, as there am usually metastases in the vertebrae. The average survival for these patients was two years, but some remarkable ex- ceptions are mentioned. For instance one patient lived eleven years and others from three to six years, due the author believes to the effectiveness of the climatotherapy. A bibliography is appended. F. BURCHEIM

Ulcerative Hodgkln’s Disease of the Skin, F. E. SENEARAND M. R. CARO. Arch. Dermat. & Syph. 35: 114-128, 1937. Twenty-seven cases of Hodgkin’s disease of the ulcerative type which the authors were able to find in the literature are reviewed and a case is added. The patient was a man twenty-three years old with enlarged axillary, cervical, and inguinal nodes first noticed about a year before. An ulcer had developed in the right axillary region and biopsy suggested Hodgkin’s disease or sarcoma. The blood count showed 3,440,000 erythrocytes and 20,700 leukocytes (16 per cent lymphocytes, 6 per cent large mono- nuclears and transitional forms, 75 per cent polymorphonuclears, 3 per cent eosinophils). Roentgen therapy was given but the patient rapidly lost strength and, though the ulcer was reduced in size, a board-like infiltration developed over the entire right side of the chest. A similar area of infiltration and a small ulcer appeared in the right infraclavicu- lar region. At autopsy histologic changes characteristic of Hodgkin’s disease were found in the cutaneous ulcer and in the lymph nodes of the anterior portion of the thoracic wall and mediastinum. In the spleen both the pulp and malpighian corpuscles contained numerous swollen reticulum cells which were atypical in form and size and had several nuclei. Reed-Sternberg cells were present in tissue from the surface of the ulcer excised a few days before death but were not found in the deeper tissues studied post mortem. A photograph of the patient and two photomicrographs are included. Carcinomatoid Malignant Reticuloma with Multiple Visceral and Bony Involvement, G. OLIVAAND R. CATTANEO.Reticoloma maligno carcinomatode a localizzazioni viscerali ed ossee multiple, Arch. per le sc. med. 61: 528-543, 1936. A twenty-year-old mechanic complained of pain in the left ear, anorexia, weakness, and malaise. One month later palpable nodes appeared in the right supraclavicular region. Node involvement became generalized and a severe intermittent fever developed. X-ray therapy, performed after biopsy, brought about marked transitory improvement, but within two months there was a recrudescence of the entire symptomatology. Intense arsenical and x-ray therapy was without benefit. Superficial swellings of the chest wall and a hemothorax appeared. Death occurred twenty-two months after the onset of symptoms. Necropsy revealed a generalized lymphatic involvement including the cervical, axillary mediastinal, para-aortic, and inguinal nodes. The pleura, liver and spleen were studded with neoplastic nodules and the skeletal system was diffusely involved. Microscopically the lymph node involvement was somewhat suggestive of metastatic EDUCATION 643 carcinoma. The tumor cells, however, were of reticulo-endothelial origin showing “ a rather coarse, often folded nuclear membrane,” as described by Klemperer (in Contributions to the Medical Sciences in honor of Dr. Emanuel Libman, International Press, N. Y., 1932, vol. 11, p. 655). Three photomicrographs are shown and there is a short bibliography. ADOLPHMELTZER

EDUCATION Educational Advantages of the Tumor Clinic, G. M. DORRANCE.Am. J. Roentgenol. 38: 636-637, 1937. The author describes the clinical conferences conducted by the American Oncologic Hospital of Philadelphia. The group study thus made possible, he believes, has done more to systematize the study of tumor treatment and to give to those participating a broader view of the subject in a period of five years than might otherwise have been obtained in twenty.