We also utilized sodium thiosulfate in many patients where symptoms such as pain, vertigo, itching, etc., could be related to a local acid pattern. In these specific cases, the results were generally satisfactory. Sodium thiosulfate was administered either orally in drops of a 10% solution in water, or parenterally in a 4% solution in water. Intramuscular and subcutaneous injections were well tolerated even when doses were as high as 10 cc. Doses as small as 10mgs. were observed to influence symptoms in certain patients. However, in some cases it was necessary to give as much as 5 gr. of the substance—125 cc. of the parenteral solution—in 24 hours to obtain any effect. In these cases there were no apparent side effects even when this dosage was continued for many days. Effects upon tumors with the use of thiosulfate alone were seen in several cases but the treatment did not produce complete disappearance and results usually were only temporary.

The use of sulfurized oil in conjunction with sodium thiosulfate has been tested in a sufficient number of cases (more than 75) to enable us to recognize that the combination produces changes in pain and systemic analysis, as well as reduction in the size of tumors, especially when given in adequate amounts over a long enough period of time. In several cases, tumors disappeared for many years following this treatment. The following are illustrative cases:

G. M.—In March 1944, this patient had an ulceration of the cervix. Biopsy showed squamous cell epithelioma, Grade III. A total hysterectomy was performed. She was treated with 3,600 mg. hours of radium in and around the cervix in April 1944. Five months later, there was evidence of local recurrence and the patient was given 1800 r. of deep X ray therapy. In July 1945, examination revealed no evidence of disease. On October 28, 1945, the patient was examined at the Scott and White clinic in Temple, Texas, and a diagnosis of extensive metastatic carcinoma of the parametria was made and further deep X ray therapy was advised. The patient refused this.

She came under our care in November 1945. She was extremely weak and showed evidence of considerable weight loss, weighing only 86 lbs. Hematuria and dysuria were the principal complaints. Multiple large tumor masses were palpable in the pelvis and extended into the abdomen above the umbilicus. The largest mass palpable, about the size of a big grapefruit, was in the right lower quadrant. The tumor was found to have invaded the bladder, too.

The treatment with which we started, t.i.d. intramuscular injections of 1 cc. of placenta fatty acids, 10% in oil, was changed after one week, in view of the preterminal condition of the patient. A hydropersulfide preparation containing 1% sulfur, and sodium thiosulfate 10% was administered orally. We started with a dose of cc. three times daily of hydropersulfide and 1/2 cc. thiosulfate and increased it progressively, with amelioration of the general condition and disappearance of the hematuria. After a month, the dosage reached 3 cc. of the first and 9 cc. of the latter preparation daily. Under this treatment, the patient continuously gained strength and weight. The hematuria did not reappear.

In May 1946, she was admitted to the University of Chicago clinic. A large fixed, firm, irregular tumor mass was still present in the lower abdomen rising from the pelvis to the umbilicus. Although her general condition had improved, the patient again had urinary frequency and urgency, and cystoscopy revealed a severe cystitis and several small stones in the bladder. An intravenous pyelogram showed a right hydro nephrosis.

The treatment with hydropersulfide and sodium thiosulfate was continued for 4 months in Chicago during which time the abdominal mass became smaller, softer, less fixed and was no longer tender. By August 1946, her weight was 136 lbs., a gain of 50 lbs. since start of treatment. The treatment was continued during 1947, although abdominal examination did not reveal any palpable masses. On rectal examination, however, the pelvis appeared to be frozen but no definite mass was felt. Cystoscopy showed severe cystitis, bladder calculi and a distorted bladder. Although she passed several stones and gravel, her urinary symptoms persisted.

In December 1948, an attempt was made in Texas to remove a bladder calculus transuretherally after lithotrity. The bladder was perforated during this procedure and a recto vasical fistula resulted. The patient's local physician in Texas believed that the patient was terminal, but we insisted upon This was done, and the surgeon reported that there was no evidence of any a colostomy to divert the fecal stream as an immediate first procedure pelvic or abdominal masses. The patient made a slow recovery. According to reports to this date. 16 years after start of treatment, no recurrence has been noted. Recently the colostomy was closed, the patient being in good condition.

Mrs. M. L.—In November 1941, at the age of 40, the patient had a left oophorectomy for a multi loculated ovarian tumor with ascites and peritoneal implants. The pathological finding was papillary cyst adenocarcinoma of the left ovary. Without any other treatment, she remained free of symptoms until the beginning of 1945, when she started to complain of abdominal discomfort in the lower left quadrant. A mass was found at the site of operation. Growth was noted in further examinations. The patient had no treatment until December 1945, when she came under our care. On examination, a tumor of 1 1/6 cm. with limited mobility was found. No abdominal fluid was present at this time. She was started on amylmercaptan in doses increasing to 6 cc. daily of a 10% solution in oil. The treatment was discontinued after a week because of the odor. No manifest changes could be seen. A preparation of hydropersulfide containing 1 % sulfur, in a dose of 1 cc. three times a day orally, was used. The mass in the left parameter disappeared entirely in about 2 months. She continued with the same medication for another 14 months. There has been no recurrence to date.

Photomicrograph of lymph node from Case E.H.

Fig. 158. Photomicrograph of lymph node from Case E.H. showing metastatic adenocarcinoma Gr III (400 x).