William McIntyre,1 an English physician, published in 1850 the report of a case of "mollities and fragilitas ossium." His description of the onset with vague neuritic pains, the occurrence of spontaneous fractures of two ribs, and of the later evolution and course of the disease combine to give a typical clinical picture of a multiple myeloma. In addition, he made an interesting observation of the peculiar "altered condition of the urine." At his request Bence-Jones2 made a study of the patient's urine and confirmed his observations. Addition of nitric acid cleared the urine, but a yellowish coagulum formed about one and one-half hours later, which, however, redissolved on application of heat and precipitated out again on cooling. The effect of boiling was to redissolve the coagulum. The postmortem examination with a particular study of the involved ribs was made by Dalrymple.3 McIntyre called attention to the essentially
THE PROBLEM OF MYELOMA. JAMA. 1935;104(16):1420. doi:10.1001/jama.1935.02760160044014
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