204 THE ENZYME TREATMENT OF CANCER
-ances it is impossible with present methods to avoid the presence of some trypsin in every amylopsin injection. A careful watch should be kept on this, that it is as little as possible—from 10 to 20 units. But even this is not sufficient. The injections used should be as freshly made up as possible, for, as will be seen, amylopsin may by some means be broken up into trypsin, and at present the conditions under which this happens are not known. It may, of course, be a change due to temperature.
In the past few years the injections have been given hypodermically, but the great advantages of the procedure adopted by Captain Lambelle, and given in his own words on a succeeding page, may be insisted upon; that is, the injections should be given “intramuscularly deeply into the muscles of the buttock, or about the iliac crest, or in the flank.” To my mind it is an unnecessarily painful procedure to give them hypodermically into the abdominal wall.
It is of the utmost importance to avoid any suspension of treatment, especially during the first four months, or until the tumour has liquefied, and its remains have shelled out or become encapsulated. There are two reasons for this. In the first place, if there be still any living portions of the tumour, even a few single cells, these may thereby have time to adapt themselves to their ferment environment, and by increased secretion of antitryptic bodies (? intracellular ferments) succeed in neutralizing the pancreatic enzymes injected. This is in complete accordance with the findings of stereo-chemistry, for when present in equal amounts, the dextro- and laevo- stereo-isomers neutralize each other, and the mixture has no action upon polarized light (Pasteur). Secondly, under such circumstances there is great danger of toxaemia, from the formation of poisonous substances