CHAPTER XVI 



EFFECTS ON THE LYMPH AND LYMPHATIC GLANDS 



Changes in the lymphoid tissue of the bone marrow have already been 

 described in Chapter VII, with the skeleton. The lymphoid tissue of the 

 alimentary canal, spleen and thymus will be considered along with these organs 

 in later chapters. The present chapter deals with the lymph and lymph glands 

 in general. Although the characteristic involution of the lymphoid tissue during 

 malnutrition usually results in atrophy of the lymph nodes, they often appear 

 swollen (especially in rickets, beriberi and scurvy), perhaps chiefly through 

 secondary infections in conditions of lowered resistance. After a brief summary, 

 the details will be presented under (.4) effects of total inanition, and (B) effects 

 of partial inanition. 



Summary of Effects on the Lymph and Lymphatic Glands 



During total inanition the quantity of lymph apparently increases during the 

 first third of the fasting period, but gradually decreases later, with changes in 

 composition. 



The lymphatic glands during inanition appear variable in size. In ema- 

 ciated human adults they are in many cases extremely atrophic, but in others 

 they appear normal in size or even enlarged (probably from secondary infections). 

 Enlargement appears more frequent in atrophic infants. In fasting animals, 

 the results are also variable, although marked atrophy of the lymph glands 

 appears characteristic. During partial inanition, changes in the size of the 

 lymph glands likewise appear somewhat inconstant, but enlargement appears 

 characteristic in rickets, beriberi and scurvy, especially in the mesenteric 

 nodes, often probably due to secondary infection. 



Microscopically, the lymphatic glands during inanition usually show a very 

 characteristic atrophy of the lymphoid tissue, even in cases where a decrease 

 in the size of the gland as a whole may be offset by a distension of the blood 

 vessels and lymph sinuses. In general, there is a marked diminution in the 

 number of lymphocytes (by emigration), which renders the less affected 

 stroma (reticulum) and trabeculae very prominent. The lymphoid nodules 

 and cords are reduced in size, and mitoses are decreased in number or absent. 

 Numerous phagocytic cells are found, often containing pigment derived from 

 excessive destruction of erythrocytes (especially in regions of hemorrhage in 

 scurvy). An increased number of phagocytes and plasma cells has been noted 

 during hibernation. Retterer's claim that lymphatic glands may be trans- 

 formed into hemolymph glands by inanition lacks confirmation. Secondary 

 infections may occasion inflammation, however, and occasionally even suppura- 

 tion of the lymphatic glands, especially in scurvy. 



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