81 Κ. Β.

Cancer of larynx

0.6884 0.0353 5.2 0.0948

4.4

was less than 2 percent of the total sulfur. Considering it from this point of view, 90.9 percent of normal cases gave a negative Salomon and Saxl reaction.

In the results for 59 urinary examinations of cases of cancer (Table 2), the colloidal-nitrogen percent was generally increased to as high as 5.75 percent of the total nitrogen, the minimum being 3.4 percent. Fifty-eight of the 59 cases of cancer gave a positive Salomon and Saxl reaction. We are doubtful whether the case in which it was negative (case 27) was one of true malignancy, the diagnosis having been made clinically.

Table 3 is the most interesting. Forty-seven cases of diseases other than cancer were studied. We obtained positive results with the colloidal-nitrogen estimations in cases of myocarditis, diabetes and syphilis. The colloidal nitrogen is constantly increased in amount in diabetics. Wallace,24 basing his conclusion on the findings in only two cases, states that this increase is not constant and that there is no relationship between the colloidal-nitrogen output and the severity of the diabetes. Tuberculosis and the other diseases gave negative results. On the other hand tuberculosis, hemophilia, pernicious anemia, and atrophic cirrhosis of the liver, gave positive Salomon and Saxl neutral-sulfur reactions, whereas the other diseases reacted negatively.

General conclusion. We conclude that positive results with either the colloidal-nitrogen test or the neutral-sulfur test, alone, are not indicative of carcinoma. When performed conjointly on urine of the same case, however, positive results with both methods are strongly indicative of malignancy.

Further work along these lines is desirable.

BIBLIOGRAPHY

1. TÖPFER: Wiener klin. Woch., 1892, v, p. 49.

2. BONDZYNSKI and GOTTLIEB: Zentralb. f. d. med. Wiss., 1897,

xxxv, p. 577.

3. SALKOWSKI: Berliner klin. Woch., 1910, xlvii, p. 1746.

4. HESS and SAXL: Beitrag. z. Carcinomforsch., 1910, part II.

5. SALKOWSKI and Kojo: Berliner klin. Woch., 1910, xlvii, p. 2297.

6. Kojo: Zeit. f. physiol. Chem., 1911, 1xxiii, p. 416.

7. EINHORN, KAHN and ROSENBLOOM: Arch. f. Verdauungskrank.,

1911, xvii, p. 557.

8. KAHN and ROSENBLOOM: BIOCHEMICAL BULLETIN, 1912, ii, p. 87.

9. VOLPE: Practiceski Vratch, 1913, xii, 84, 105.

10. MANCINI: Deut. Arch. f. klin. Med., 1911, ciii, p. 288.

11. SEMIONOV: Russki Vratch, 1913, xii, p. 576.

12. KONIKOV: Ibid., 1913, xii, p. 927.

13. MARCEL, LABBÉ and DAUPHIN: Compt.rend. soc. biol., 1913, 1xxv,

p. 391.

14. CARFORIO: Berl. klin. Woch., October, 1911.

15. SALOMON and SAXL: Deut. med. Woch., 1912, xxxviii, p. 58.

16. PETERSEN: Ibid., 1912, xxxviii, p. 1536.

17. Dozzi: Gaz. degli Ospedali e delle Cliniche, 1912, xxxiv, p. 1007.

18. MURACHI: Biochem. Zeit., 1913, xli, p. 138.

19. PRIBRAM: Wien. klin. Woch., 1912, xxiv, p. 1235.

20. ALEKSEEV: Russki Vratch, 1913, xii, p. 319.

21. MAZZITELLI: Jour. Amer. Med. Assoc. (abstract), 1913, lix, p. 978.

22. GREENWALD: Archiv. Int. Med., 1913, xii, p. 283.

23. STADTMÜLLER and RoseNBLOOM: Ibid., 1913, xii, p. 276.

24. WALLACE: Proc. Soc. Exp. Biol. and Med., 1914, xi, p. 113.

ACTIVE IMMUNIZATION TO HAY FEVER*

MARK J. GOTTLIEB AND SEYMOUR OPPENHEIMER (Laboratory of Biological Chemistry of Columbia University, at the College of Physicians and Surgeons, and the Laboratory of Clinical Research, 45 East 60th St., New York, N. Y.)

INTRODUCTION. Hay fever, or pollinosis, is a disease which manifests itself in the spring, from the latter part of May or the early part of June to the early part or middle of July; and in the autumn, from the middle of August to the end of September or early October. It is characterized by itching of the eyes and lachrymation, sneezing, serous discharge from the nose, obstructed breathing, and itching of the palate and face. If the attack is very severe, sooner or later there is coughing, and difficult breathing accompanied by wheezing. It is caused by the action of pollen grains from flowering plants, the pollen being carried by air currents and thus inhaled. If the recipient is susceptible to a particular pollen, an attack of hay fever promptly ensues.

In 1906 Wolff-Eisner (1) suggested that this disease was a condition of anaphylaxis. Dunbar (2) has studied the subject exhaustively and claims that, besides hypersusceptibility to the pollen "toxin," there must be, in patients subject to this condition, an abnormal permeability of the skin and mucous membranes for the pollen substances. This last fact we have demonstrated to my own satisfaction by dropping a small quantity of pollen on the skin of the face, when redness and itching were soon manifest; also by dropping a minute quantity of pollen on the conjunctiva, in a very short time redness and swelling of the lids occurring.

Richét and Hericourt (3) in 1898 applied the name of anaphylaxis to a symptom complex of vomiting, diarrhea, respiratory distress, and sometimes death, which was produced in animals by a sublethal dose of toxic protein, or by a dose of non-toxic protein, fol