210 THE PROTEOMORPHIC THEORY AND THE NEW MEDICINE 



suggestive clues as to the origin of this obscure disorder. A 

 tenable hypothesis would appear to be that degenerative changes 

 had taken place in the particular cells of the bone marrow that 

 normally produce polynuclear leucocytes; involving also, to a 

 less extent, associated mother-cells of the erythrocytes. To 

 meet this deficiency, unusual cohorts of small lymphocytes were 

 called into action; and as the need persisted, and was perhaps 

 progressively aggravated with progressive degeneration of the 

 cytogenic apparatus in the bone marrow, there was hyperplasia 

 of the entire lymphatic system (roughly analogous to the compen- 

 satory hypertrophy of heart muscles to maintain an obstructed 

 circulation), of which tangible evidence was given in the observ- 

 able enlargement of the lymphatic glands in many regions. 



Observation of the smear before Proteal treatment was admin- 

 istered, taken in connection with the clinical symptoms, appears 

 to justify the inference that small lymphocytes in superabundance 

 may on occasion perform the totality of leucocytic labors plus 

 a certain amount of the work of the red cells, maintaining a fair 

 semblance of normal bodily metabolism. 



It would appear that the Proteals stimulated the mother-cells 

 of the large monocytes effectively, and that these cells were able 

 to take the work off the small lymphocytes to such an extent that 

 the enlarged lymphatic glands could be reduced ; such reduction 

 being perhaps facilitated by direct activities of the large mono- 

 cytes, as has been repeatedly observed in cases showing malignant 

 metastatic involvement of the lymphatics. 



The appearance of increased numbers of polynuclears, albeit 

 in an embryonic or degenerative condition, suggests that possibly 

 the Proteals have been able to stimulate to some extent the ex- 

 hausted mother-cells of this type of leucocytes. Such stimula- 

 tion has apparently not been very effective hitherto, however, and 

 the stimulus to the mother-cells of the erythrocytes has seemingly 

 been even less effective, since the number of these cells, although 

 fluctuating (at one time reaching 3,400,000), has on the whole 

 failed to increase. It should be remarked, however, that the 

 possibilities of Proteal stimulation in this direction have been 

 by no means exhausted ; inasmuch as the dose administered has 

 not been increased above eight minims. The treatment has been 

 carried out under somewhat disadvantageous circumstances, the 

 patient coming to my office only occasionally, and in the main de- 

 pending upon home administration. Moreover, it has been 

 thought well to advance cautiously in view of the extraordinary 

 blood conditions to be dealt with. 



Fuller history of the case awaits later presentation ; I have 

 dwelt on it here because of the interesting sidelights that it throws 

 on the Proteomorphic theory, and because of the conspicuous 



