298 REVIEWS. 



The subsequent history of the patient is remarkable. About 

 a year after the disease had reached its cHmax, nearly two 

 years after its commencement, a marked improvement took 

 place in all the symptoms, and on examination of the blood 

 it was found to contain not a single microcyte, the red and 

 white corpuscles being normal, and present in normal pro- 

 portions, the only noticeable fact being that the red cor- 

 puscles were rather small. 



Analysing the morbid phenomena presented by this case, 

 the authors first discuss the enlargement of the spleen. This 

 was clearly not due to amyloid degeneration, since this did 

 not show itself in .any other organ ; nor was it the hyper- 

 trophy which is accompanied by leukaemia, the latter symp- 

 tom being absent. It was equally distinct from the enlarge- 

 ment due to intermittent fever, and from the temporary 

 swelling observed in typhoid or other febrile affections ; in 

 fact, it appeared to be an affection sui generis. 



The same might be said to be true of the enlargement and 

 subsequent atrophy of the liver, this being not referable to 

 any of the ordinary causes of atrophy of this gland. 



As to the small globules seen in the blood of this patient, 

 they were decidedly different from the ordinary red globules 

 — first, in their smaller size ; secondly, in their spherical 

 shape. Bodies somewhat similar have been seen by various 

 observers. Lehmann first noticed that the red globules of 

 the portal vein were smaller and more spherical than those of 

 other parts of the circulatory system, and unusually resistant 

 to the action of water and acetic acid. Funke saw similar 

 globules in the splenic vein. Max Schultze described red 

 globules smaller than the ordinary ones, and of spherical 

 shape, either crenated or granular, from the blood of several 

 persons ; and this observation was confirmed by Klebs, who 

 described also some small spherical globules having a uniform 

 surface ; none of these observations, however, precisely 

 accords with that of the author's. Schultze was unable to 

 decide with perfect certainty whether the globules observed 

 by him were pre- existent in the blood, or altered after 

 removal from the vessels. The authors have, however, been 

 able to determine positively that their " microcytes" existed 

 as such in the blood. 



The distinctive characters of microcytes are summed up as 

 follows : — Perfectly spherical form, remarkable permanence 

 of shape, power of resistance to reagents, constant isolation 

 in the field of the microscope, excessive refractive power, 

 smallness and uniformity of size. In attempting to define 

 their physiological nature two suggestions are made — that 



