148 THE PROTEOMORPHIC THEORY AND THE NEW MEDICINE 



given prevalence of full-sized protein molecules, when the large 

 mononuclears are few, they would individually secure large in- 

 crements of pabulum, and would on the average be disrupted 

 when this pabulum has reached the proteose stage, thus necessi- 

 tating a full equipment of small lymphocytes to take up the work 

 of hydrolyses. On the other hand, if without increase of pro- 

 tein pabulum, the number of large monocytes is increased, we 

 may assume that on the average they would carry the work of 

 decompounding to a lower stage, possibly even to the peptone 

 stage, and hence be able to turn their product over directly to the 

 neutrophiles, thus to some extent rendering the presence of small 

 lymphocytes superfluous. Some blood charts have been pre- 

 sented which seem to give plausibility to this suggested com- 

 plementary relation between the activities of the large and small 

 monocytes. 



Applying the same line of reasoning to other types of leuco- 

 cytes, we may assume that under exceptional circumstances, the 

 small lymphocyte may be able to deal with the full-sized protein 

 molecule on one hand and to bring it to something approaching 

 the polypeptid stage on the other hand ; thus supplementing the 

 functions of large monocytes and of polynuclears. Cases of 

 lymphatic leukaemia suggest this possibility. Meantime the poly- 

 nuclear itself, although ordinarily concerned with transforming 

 peptones into polypeptids may conceivably on occasion deal with 

 proteose on one hand and carry the polypeptids toward the amino- 

 acid stage on the other. A certain complementary relation ob- 

 servable between the mononuclears, as a group, and the poly- 

 nuclears, in the charts before referred to, may perhaps thus be 

 explained. That a full red-cell equipment minimizes to some 

 extent the need of the services of polynuclears is also at least a 

 tenable hypothesis. 



I have under treatment a patient who for months has main- 

 tained a clinical status of fairly robust health with a red-cell 

 equipment of from 2,176,000 to 3,909,000, and a leucocyte count 

 (chiefly small lymphocytes) ranging from 680,000 to 1,412,000. 

 On the smear, the small lymphocytes are like bunches of grapes ; 

 large mononuclears with obscure nuclei are abundant ; but poly- 

 nuclears are hard to find. Here it is impossible to avoid the 

 inference that the small lymphocytes perform functions normally 

 reserved for polynuclears on one hand and erythrocytes on the 

 other. This interesting case of lymphatic leuksemia will be dis- 

 cussed in greater detail elsewhere. 



It is probable that another factor that may disturb the mutual 

 relations of the white corpuscles is to be found in the relative 

 amount of fat to be dealt with in any organism. I have sug- 

 gested that the polynuclears may have a share in dealing with 



