THE SCIENCE AND ART OF PROTEAL THERAPY 155 



dant; and we have seen that such is the condition also in un- 

 treated cases of cancer, and in various other conditions of dis- 

 turbed protein metabolism, including intestinal toxaemia; subject, 

 however, to the modifying consideration that an excessive stim- 

 ulus may for a prolonged period have led to exhaustion of the 

 blood-forming organs, bringing about a leukopcenia. 



As opposed to this line of reasoning, it is perhaps worth con- 

 sidering that the polynuclear appears to be the most highly dif- 

 ferential of leucocytes, and that inferentially it might be sup- 

 posed to deal with the higher proteins rather than with fats and 

 hydrolysis product. Obviously, the question calls for further 

 experimental evidence. 



As to the different types of large monocytes, I am disposed 

 to regard lymphoidocytes, myelocytes of the different types, and 

 cells of the kind designated by Papenheim as leucoblasts, as be- 

 longing to the same series with typical large monocytes, the latter 

 being mature and actively functional examples of this type of 

 cell. It is true that the myelocyte is usually regarded as of the 

 granular series, and the large monocyte as of the non-granular ; 

 but, in my opinion, this distinction does not connote an actual 

 difference of origin or ultimate structure, but only divers stages 

 of development. 



There is another type of large mononuclear leucocytes which 

 I believe to be merely an overgrown lymphocyte. The presence 

 of these large lymphocytes indicates activity of development of 

 the lymphocyte population. Not infrequently in the course of 

 Proteal treatment it will be observed that all the lymphocytes 

 increase in average size, and many come to such proportions 

 as to be classified as large lymphocytes, whereas at the begin- 

 ning there was but a minimum number, or even none at all, of 

 this type of actively functional lymphocytes. 



Whereas the typical large monocyte (including the so-called 

 "transitional" type), with its relatively deep-staining nucleus and 

 basic cytoplasm, is the cell that I like to see represented in in- 

 creasing coteries under Proteal treatment, I am disposed to 

 think that the typical large lymphocyte works hand in hand, so 

 to speak, with its congener in dealing with the foreign proteins. 

 Whether one type of cell of a preference deals with the un- 

 broken protein molecule and another with the partially hydrolyzed 

 molecule (peptone, proteose) is a question regarding which opin- 

 ion must as yet be held in abeyance, although observations are 

 in hand that at least prepare the way for the ultimate elucida- 

 tion of this aspect of the problem. 



The fact that under Proteal treatment there is coincident in- 

 crease in numbers and betterment of quality of large monocytes 

 and of red corpuscles, suggests a possible common origin for these 



