The actual acidity of the urine, as measured by the oxalic acid and phenolphthalein test, is also of the greatest importance. This is not difficult of application and is daily used in my laboratory; the litmus paper test is of relatively little value in comparison with an actual chemical measurement. Thus, with an average standard of 300 we not infrequently find an acidity of 500 or 600, or even 1000 or more, or it may sink to 200 or 100, or even be strongly alkaline. In cancer I have striven, by diet and remedies, to keep it a little below normal, as it has been shown that the blood in this disease exhibits a constantly increasing tendency to diminished alkalescence, or, wrongly called, increased acidity.
But further and very careful volumetrical urinary analysis is very important to determine and maintain the metabolism in its proper condition. Time does not permit such an elaboration of this subject as might be desired, and I can only call your attention briefly to some of the points brought out in my former lectures.
Many observers have found the nitrogenous disintegration very imperfect in cancer cases, and oxyproteic acids are increased and even that in very early cancer. An increase of amino-acid nitrogen was found by Reid in practically every case studied. Others have found an increase in colloid nitrogen, to more than double the normal amount, and also increased elimination of xanthin and urinary ammonia; so that all observers testify to a disturbed nitrogen partition in cancer. The elimination of urea is certainly greatly diminished, even in early stages and when on a full diet, as I have almost invariably observed.
The sulphur partition is also found to be imperfect, in new and old cancer cases, and even a great increase in the urinary discharge of sulphates is constantly noticed in my analyses. Associated with these errors in the nitrogenous and sulphur element is the very common and persistent increase of indican, showing stasis in the small intestine, with bacterial putrefaction.
Imperfect intestinal elimination is constantly observed in cancer cases, both habitually and in the very early, formative period, and also later, even before any recourse to morphin, which, of course, heightens the trouble. In recording the statements of these patients I have been so struck with the almost invariable history of constipation before the first appearance or suspicion of the cancer that I cannot help feeling very strongly the possibility that the toxins produced by the millions of microörganisms, generated through intestinal stasis and fecal putrefaction, play a great part in the production of that blood dyscrasia which culminates in the formation of the malignant new growth.