consequent upon Inflammations of acute local Character. 197 



It is important in interpreting the significance of the inflammatory 

 leucocytopenia to remember that the granular (= irregularly nu- 

 cleate) hfemic leucocytes appear more adhesive than the hyaline 

 (mononuclear, regularly nucleate). In the " balling " of leucocytes 

 which so readily occurs in peptone blood, I have often noticed that the 

 clumps of leucocytes may be formed almost exclusively of granular 

 leucocytes, while many hyaline leucocytes are free in the plasma. In 

 oxalated blood the granular leucocytes adhere to the masses of plate- 

 lets disproportionately in comparison with the lymphocytes ; they 

 are not raerelv adherent to the surface of the masses but many are 

 entangled and often remain for a time hidden in the masses. It is in- 

 teresting to watch how those temporarily buried work their way to 

 the surface. At first they appear like fusiform fibroblasts directed so 

 as to radiate from the centre of the ball-shaped mass as it lies flat- 

 tened between object-slide and cover-slip. The elongated nucleus is 

 the chief sign of the cell, and this can be noted slowly slipping 

 toward the periphery of the ball. As it approaches the free surface 

 of the mass the cell glides more quickly, and finally it emerges with 

 an almost sudden plunge and ranges itself beside the other similar 

 leucocytes already sticking to the surface of the clump. Had one not 

 seen the steps of the process one might have imagined that the cells 

 covering the mass of precipitate had wandered to it on account of 

 its nutritive nature (proteid) and in obedience to positive chemo- 

 taxis. As a fact however most at least of the cells have been merely 

 mechanically entangled in the mass and gradually get out of it 

 and then stick for a while to its free surface. 



It must be remembered also that the hyaline leucocytes are not so 

 amoeboid as the granular ; the small variety of them not at all. 

 Emigration will remove from the circulation more individuals of the 

 granular than of the hyaline types. The granular leucocytes tend 

 disproportionately numerously to adhere and escape in the vascular 

 region of the local inflammation. This would increase the relative 

 number of hyaline cells to granular in the general circulation. 



Other possible factors may be briefly alluded to. Many of the 

 ibstances that when injected into the circulation cause leucocyto- 

 enia are the lympliagogues of Heidenhain.* They belong to that 

 class of lymph agogues which increase the flow of lymph from the 

 loracic duct by hastening the transfer of fluid from the blood into 

 le lymph spaces. Heidenhain showed that in the dog these lympha- 

 Dgues, although increasing the volume and organic richness of the 

 output of lymph, via thoracic duct, reduce the volume and organic 

 richness of the serum of the blood itself. Lowitf has shown that in 

 the rabbit, as result of intravenous injection of albumose, &c., the 



* Op. cit. 

 t Op. cit. 

 VOL. LV. P 



