Is the Catalytic Activity of Bence Jones Proteins an Autoimmune Effector Mechanism in Multiple Myeloma

On Friday, October 30, 1845, W. MacIntire, physician to the Metropolitan Convalescent Institution and to the Western General Dispensary, St. Marylebone, was called to see a patient who had been treated by T. Watson for several months (1,2). Since the patient had a history of edema, Maclntire examined the urine and noted the peculiar physical properties of the urinary protein (precipitation with heating at 40–60°C, disappearance with boiling, and reappearance with cooling). He wrote: “I was at first inclined to think that some mistake had occurred, but on repeated trials with other specimens, and closely watching their course, the results were always found to be the same” (2). Watson had evidently not examined the urine when the patient had been under his care, but was present when Maclntire performed urinalysis. In those days, it was customary for the specialist services to be provided by practicing physicians and surgeons. Urine specimens were sent to Henry Bence Jones, physician to St. George’s Hospital and professor of forensic medicine of the Medical College associated with the Hospital. Jones was then 31 yr old, but had already established a reputation as a chemical pathologist. He confirmed the Maclntire results and examined the protein in some detail. The patient died six weeks later, and an autopsy was performed by Shaw, surgeon to the Middlesex Hospital, in the presence of Watson, Jones, Ridge, and Maclntire, none of whom thought that the peculiar urinary protein was related to the disease, mollities ossium, later called multiple myeloma (2).