262 INANITION AND MALNUTRITION 



Cirrhosis of the lymph glands has been noted in pellagra. The lymphoid 

 tissue appears especially sensitive to a dietary deficiency of fat, while in rickets 

 a general lymphoid hyperplasia appears characteristic. A deficiency in vitamins 

 (especially of vitamin B) tends to cause a general atrophy of the lymphoid 

 tissue, associated with lymphopenia in the circulating blood. During chronic 

 thirst, the changes in the lymph nodes resemble those typical for inanition in 

 general, with hyperemia and lymphoid atrophy. 



Although there are numerous variations, the changes in the structure of the 

 lymphatic glands during inanition in general resemble those found in the other 

 lymphoid organs, including the bursa of Fabricius ("cloacal thymus" in birds), 

 bone marrow (considered with the skeleton) and the thymus, spleen and intes- 

 tinal lymphoid structures (to be considered in later chapters). 



Upon adequate refeeding after inanition, the lymphatic glands in general 

 recuperate promptly, showing rapid increase of weight, associated with active 

 mitosis and recovery of normal structure in the lymphoid tissue. 



(A) Effects of Total Inanition, or on Water Only 



The effects will be considered first in man, adult and infant, and then in 

 the lower animals. 



The observations upon the effects of inanition on the lymphatic system of 

 the human adult appear rather scarce. In autopsies upon emaciated victims 

 of the Madras famine (226 men, 155 women and 78 children), Porter ('89) found 

 the mesenteric lymph glands nearly normal in size in about a third of the adults 

 and five-sixths of the children (57 men, 37 women and 51 children). They were 

 enlarged and swollen (probably chiefly through infections) in 36 men, 6 women 

 and 11 children, and were extremely atrophied in 73 men, 74 women and 2 

 children. Pigmentation of the glands was noted in 12 men, 8 women and 

 2 children. In 12 cases (4 men, 4 women, 4 children) of extreme emaciation 

 without evident complications, the mesenteric glands appeared about normal 

 in size in 1 man, 3 women and all 4 children; much enlarged in 1 man; and 

 atrophied in 2 men and 1 woman. 



In an adult man who died of starvation (60 days on water only) with loss of 

 about 40 per cent in body weight, Meyer ('17) carefully studied the lymph 

 nodes, 18 hours post mortem. "The inguinal lymph nodes were barely palpable 

 on both sides, and all except the medial nodes, which were slightly reddish, were 

 pale. The mesenteric nodes were small and pale, but numerous. The pre- 

 vertebral nodes formed a chain of soft, flat, pale bodies, and the only very red 

 specimens were a pair of iliac nodes, one on each side. That on the right was 

 1 X 0.5 centimeters and only a few millimeters thick. That on the left was very 

 much smaller. There was nothing noteworthy about the rest of the nodes of 

 the entire body. Some of the right bronchial nodes were calcified. The 

 cysterna chyli contained a little yellowish fluid." 



Microscopic examination revealed the following: 



"Iliac Nodes. — The parenchyma especially of these lymph nodes is very 

 much depleted and some portions of the nodes are comprised of the collapsed 



