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August 12, 1939


JAMA. 1939;113(7):596. doi:10.1001/jama.1939.02800320048012

The first significant advance in the study of the metabolism of tumors was made by Warburg,1 who developed evidence of an altered carbohydrate metabolism of tumors. Thus was shown the ability of tumors to ferment aerobically from 90 to 95 per cent of available dextrose with the formation of lactic acid instead of oxidizing the carbohydrate to carbon dioxide and water as in normal tissue metabolism. This abnormal type of metabolism is not limited to malignant tissue, however. It has been found to be characteristic of all fast growing tissues. Kögl and Erxleben2 have recently reported that several amino acids in malignant tissues occur as the unnatural stereo-isomers. While the significance of this remarkable fact cannot now be adequately evaluated, it is the first definite evidence of a qualitative difference in the metabolism of normal and malignant tissues.

An analysis of the protein hydrolysates of four malignant tumors