DISEASES OF THE SPEEEN. 



No guidance through palpation or secretion. Leukccmia. Lymphade- 

 niona. Spleen a favorite culture ground for microbes. Congestions, en- 

 gorgements, ruptures. Safety valve to portal system and liver. Rhythmic 

 splenic contractions under reflex action. 



The spleen even more than the pancreas is so deeply' seated 

 and .so surrounded by other organs, that its diseases are not 

 readil}' appreciable by physical examination, while the absence 

 of any special secretion excludes the possibilit}' of diagnostic de- 

 ductions through this channel. Even the relation of the con- 

 dition of the organ to the number of the leucocytes and red 

 globules fails to afford tru.st\vorth}' indications of disease, since 

 leucocytes originate in other tissues as well as the spleen, and the 

 destruction of red globules may take place elsewhere. Yet an 

 excess of eosinophile leucocytes in the blood suggests hypertro- 

 ph}'- or disease of the spleen, and an excess of leucocytes in 

 general is somewhat less suggestive of disease of this organ 

 (.see Leucocythaemia). If adenoma is further shown, in en- 

 largement of lymphatic glands elsewhere there is the .stronger 

 reason to infer disease of the spleen. 



The physiological relation of the spleen to the blood especially 

 predispo.ses it to diseases in which the blood is involved. The 

 termination of splenic capillaries, in the pulp cavities, so that the 

 blood is poured into these spaces and delayed there, opens the 

 way, not only for the increase of the leucocytes, and the disinte- 

 gration of red globules, but for the multiplication of microorgan- 

 isms which ma}' be present in the blood, and for a poi.soning 

 (local and general) with their toxins. Hence we explain the 

 congestions, sanguineous engorgements and ruptures of the spleen 

 in certain microbian diseases (anthrax. Southern cattle fever, 

 septicaemia, etc.) 



We should further bear in mind that the spleen is in a sense a 

 safety valve for the blood of the portal vein, when supplied in ex- 

 cess during digestion. In this way it protects the liver again.st 

 sudden and dangerous engorgements, but it is itself subjected to 

 extreme alternations of va.sctilar plenitude and relative deficiency. 



35 545 



