During the period when mercaptans and other sulfur containing agents were being studied, attention also was centered on butanol in the group of anti fatty acid agents. While butanol's effect upon pain and other subjective manifestations appeared evident from the beginning of its use, the influence upon tumors seemed small. Together with glycerol, however, it produced several long lasting objective changes. Characteristically, in most of these cases recurrences appeared only after many years of normal active life during which there was no clinical manifestation of cancer. In some cases, however, there were no recurrences.

Myelogram of patient M.H.

Fig. 167. Myelogram of patient M.H. showing the flow of lipoidol arrested at the level of 4-T.

Mrs. M. H.—This 45-year old patient experienced, in June 1943, sensory and motor disturbances which progressed so rapidly that in September 1943 she presented a complete paraplegia below 4-T. She came under our care in February 1944, a paraplegic for 5 1/2 months. The myelogram taken at that time showed complete obstruction, with the flow of lipoidol arrested within the spinal canal at the level of the 4-T. (Fig. 167)

The urine analyses showed an offbalance of the type A, and she was treated with the acid lipid fraction of human placenta, and with hydro persulfides. The symptoms continued to progress and the pain was more severe. Following a change in the urine analyses toward the offbalance D, the treatment was changed to butanol and glycerol. The pain was controlled in a few days, and a slow regression of the paraplegia occurred. After four months of this treatment, there was complete remission and the patient was again ambulatory. The myelogram repeated at the end of November 1944, showed complete disappearance of the obstruction. (Fig. 168) The patient remained entirely well, without treatment and free of symptoms for eleven years. We were informed that, subsequently, a recurrence appeared, followed again by paraplegia and multiple lung metastases. The patient died after four months of paraplegia.

Myelogram of the patient M.H., showing the complete disappearance of the obstruction

Fig. 168. Myelogram of the patient M.H., showing the complete disappearance of the obstruction.

Mr. I. H.—In 1938, at the age of 30, the patient underwent surgery for a tumor of the right parotid diagnosed as chondromyxosarcoma; in 1940, a recurrent tumor was removed and was followed this time by facial paralysis. In 1943, another recurrence was treated surgically. In June 1945, the same procedure was repeated. Immediately after the last operation, there was still another recurrence and the tumor this time started to grow rapidly. Severe pain was only slighdy relieved by narcotics. Radiotherapy was refused, in spite of the massive tumor and pain.

The patient came under our care in December 1945, with several tumors occupying the right parotid region and extending below the man dibula. He was using various narcotics with little effect. With the urinary chloride retention index, pH and specific gravity as criteria, treatment with sodium thiosulfate and hydropersulfides was started. Under this treatment, which lasted a week, the lesion appeared to be unfavorably influenced and pain increased. With the urine chloride index used as a criterion, the treatment was changed. 1 cc. of butanol 6.5% was administered orally three times a day along with 0.3 cc. of glycerol. After 4 days, the dose of butanol was increased to 2 cc. three times a day. Pain was relieved in a few days. Rapid disappearance of the tumor masses followed. The same treatment was continued for one year. Since then, the patient has been well and is enjoying good health without any recurrence as of this date. (Fig. 169)

Patient I.H. with a recurrent chondromyxosarcoma

Fig. 169. Patient I.H. with a recurrent chondromyxosarcoma of the right parotid gland before and after treatment. The scar is from repeated previous surgical interventions.

E. M.—In 1935, at the age of 42, this patient had a right radical mastectomy for adenocarcinoma of the breast. In 1940, recurrent nodules appeared in the line of the scar. One of these was biopsied and showed a recurrent adenocarcinoma, Grade III. The patient was then treated with deep X ray therapy, 3800 r. being delivered through five fields to the right chest and axillary regions. A daily dose of 200 r. was given for nineteen days between December 1940 and January 1941, using the following factors: 200 kv., 25 ma., 50 cm., 1/2 mm. Cu and 1 mm. A1 filter. In May 1941, the wound area and recurrent nodules (Fig. 170) were excised and a skin graft was used to repair the defect.

In July 1943, skeletal metastases, predominantly osteolytic in nature, were reported in the fourth, fifth and twelfth thoracic vertabrae and first, second, fourth and fifth lumbar vertebrae, the first sacral segment and the left ala of the sacrum. There was also involvement of the outer portion of the left ilium and the inner portion of the right ilium near the sacroiliac joint. The patient received a second course of deep X ray therapy over the spine and posterior pelvis, the total dose being 3800 r. with the same factors. Following this, her menses ceased. The pain in her back, which had confined her to bed, was considerably relieved and she became ambulatory.