lation of the food, is regulated in such a way that more nutritive material can be absorbed than is immediately required by the organism. Part of the excess is stored as fat. But this condition is disturbed by the presence of a rapidly growing mass of cells with an enormously increased nutritive capacity. At first, the demands made by the tumourcells necessitate a larger intake of food and a more rapid absorption of nutritive material, so that at first the organism serving as a host to the tumour grows more rapidly. The increased activity of the digestive organs probably accounts for the condition which we observed some years ago in mice with transplanted tumours, and which has since been independently studied by Copeman and Hake, namely the increased secretion of hydrochloric acid in the gastric juice of these animals. Then, as the tumour goes on growing, the animal, instead of being able to absorb more nutritive material than is wanted immediately, will have to use all the material it can absorb in order to satisfy the growing demands of the tumour, and will not have an opportunity of storing part of the absorbed food as fat. Finally, however, the requirements of the tumour will increase to such an extent that they will overstep the limit within which a physiological adaptation is possible. The organism of the host, unable to absorb sufficient nutritive material, will have to yield nutritive material from its own tissues to the tumour. The animals then become emaciated and die within 1-2 days. The tumour rats of Litter B had not yet reached this stage. This condition was studied in six young rats of another batch, Litter A, which was inoculated on the same day as Litter B and with the same tumour, but with a bigger dose (O'2 cc.). The tumours grew much more rapidly than those of Litter B. The growth of the animals was retarded, and all the animals died within the third week after the transplantation in an emaciated condition. The gaseous metabolism of these animals although at first quite normal, began to show irregularities after the second week, and abnormally high quotients of the value ⚫86, and even 1.00 were observed in the fasting animals. These quotients were the result of a diminished O, absorption, not of an increased CO2 excretion. These observations will however not be discussed here in detail. They are mentioned only in order to emphasize that the growth of a tumour in a normal organism leads at first to physiological changes; pathological changes in the general metabolism do not ensue until the physiological resources of the animal have become exhausted. This must be borne in mind in future investigations on the metabolism of cancer if confusion and contradiction are to be avoided. The effect which a growing tumour produces on a normal organism is a problem of nutrition similar to the growth of a fœtus in a pregnant animal. It cannot be explained by attributing to the cancer cell the formation of pathogenic substances of a hypothetical nature, such as a cancer ferment or a cancer toxin." In a review of recent work on 66 66 66 * this subject the present position has been summed up as follows :'The experimental investigation of cancer has not produced any evidence in favour of the existence of a specific cancer toxin. But it has shown that cancer affects the organism in which it grows by virtue of the increased nutritive capacity of the cancer cells." Our observations on the gaseous metabolism afford further evidence in favour of this view. * W. Cramer: 'Some problems of the metabolism of cancer from the standpoint of Experimental Cancer Research' in Von Noorden-Walker Hall: 'Metabolism and Practical Medicine,' vol. iii. p. 824. APPENDIX I. BIBLIOGRAPHY OF ALL COMMUNICATIONS FROM THE LABORATORY OF THE IMPERIAL CANCER RESEARCH FUND. 1903. The Problems of Cancer. By E. F. BASHFORD, M.D. British Medical Journal, July 18, 1903. First Annual Report of the Cancer Research Fund. Taylor & Francis, Red Lion Court, Fleet Street, London *. Remarks in Verhandlungen des Komités für Krebsforschung,' October 1903. Vide also British Medical Journal, December 12, 1903. 1904. The Significance of the Zoological Distribution, the Nature of the Mitoses, and the Transmissibility of Cancer. By E. F. BASHFORD, M.D., and J. A. MURRAY, M.B., B.Sc. Roy. Soc. Proc. Jan. 12, 1904. The Zoological Distribution of Cancer. By E. F. BASHFORD, M.D., and J. A. MURRAY, M.B., B.Sc. First Scientific Report on the Investigations of the Cancer Research Fund, March 1904. The Transmissibility of Malignant New Growths from one Animal to another. Ibidem. Comparative Cytological Characters of Malignant New Growths. Ibidem. Certain Biological Aspects in the General Pathology of Malignant New Growths. By J. A. MURRAY, M.B., B.Sc. British Association for the Advancement of Science, Section D, Cambridge, 1904. * The Annual Reports are business reports presented to the General Committee at the end of each financial year, and must be distinguished from the Scientific Reports. The Annual Reports contain a short summary of the work for each year. Second Annual Report of the Cancer Research Fund. Taylor & Francis, Red Lion Court, Fleet Street, London. The Comparative Study of Cancer. By E. F. BASHFORD, M.D. The Sanitary Institute Congress at Glasgow. Journal of the Sanitary Institute, vol. xxv. 1904. 1905. The Growth of Cancer. By E. F. BASHFORD, M.D. Discussion on Spontaneous Healing. Transactions of the Medical Society of London, vol. xxviii. 1905. Ueber die Etiologie des Krebses. Von E. F. BASHFORD, M.D. Die Medizinische Klinik, No. 22, 1905. Limitations to the Statistical Investigation of Cancer. By E. F. BASHFORD, M.D., and J. A. MURRAY, M.B., B.Sc. Second Scientific Report of the Imperial Cancer Research Fund.-Part I. The Statistical Investigation of Cancer. March 31, 1905. Bearing of Biological and Experimental Investigations on Statistics of Cancer. Ibidem. Fallacies inherent in a Cancer Census. Ibidem. Uniformity in Hospital Statistics. Ibidem. Recognition of Cancer. Ibidem. Importance of Microscopical Investigation. Ibidem. Comparison of the Clinical Manifestations with the Results of Microscopical Examination. Ibidem. Distribution of Carcinoma and Sarcoma in the Body at different AgePeriods. Ibidem. Analysis of the Clinical Symptoms of Malignant New Growths which could not be recognised as such during Life. Ibidem. Age Incidence of Cancer. Ibidem. Discrepancy between the recorded Cancer Death-rate in Ireland and in Great Britain. Ibidem. Ethnological Distribution of Cancer. Ibidem. Bearing of the provisional Results upon the reputed Increase of Cancer. Ibidem. Bearing of Statistical Inquiries on the Investigation of Cancer. Ibidem. Imperial Cancer Research Fund.-Part 2. The Growth of Cancer Method of Transplantation. Ibidem., Part ii. General Results of Transplanting Sporadic Tumours of apparently similar Nature. Ibidem., Part ii. |