THE ADRENALS, LEUCOCYTOSIS AND PHAGOCYTOSIS. 613 



polymorphonuclear variety, included among those which Metch- 

 nikoff termed microphages, usually predominating. Leucocy- 

 tosis has been the source of considerable controversy. Some 

 investigators have connected it directly with phagocytosis; 

 others have ascribed to leucocytes the production of substances 

 destined to endow the blood-plasma with antitoxic properties. 

 That leucocytosis especially attends, besides leukemia, infec- 

 tious and inflammatory disorders, pneumonia, suppurative 

 processes, rheumatism, etc., is well known. Inflammatory dis- 

 eases of serous membranes, peritonitis, pericarditis, menin- 

 gitis, etc., malignant tumors, wasting diseases, haemorrhages, 

 etc., also show it at times. Various drugs produce leucocyto- 

 sis, and it often follows cold baths, massage, and other stimu- 

 lating measures. It is normally present in the newborn and 

 often occurs during pregnancy, digestion, after violent exer- 

 cise, etc.: the "physiological" form observed in normal subjects. 



In contradistinction to leucocytosis is hypoleucocytosis: 

 a condition in which the leucocytes are decreased. This is 

 met with in typhoid fever, acute tuberculosis, lobar pneumonia, 

 influenza, tubercular pleurisy, measles, inanition, etc. The 

 causes of this condition may be said to be at least obscure, 

 judging from the .variety of doctrines vouchsafed by as many 

 investigators and based upon contradictory experiments. In- 

 deed, while some have observed leucocytosis in a given disease, 

 other experimenters fully as reliable have witnessed hypoleu- 

 cocytosis. While some have observed a primary decrease of 

 leucocytes after the injection of toxic substances into the 

 blood, others have noted that the capillaries of various organs, 

 including the liver and the lungs, were crowded with leucocytes 

 during this stage. That considerable uncertainty reigns as to 

 the nature and purposes of leucocytosis is evident. 



Leucocytosis, however, seems to present many bonds of 

 association with phagocytosis, while the functions of the ad- 

 renal system as described in this work seem related to both. 

 A rapid increase of leucocytes, say, from 3000 to 10,000, in 

 typhoid fever, for instance, is thought to indicate that perfo- 

 ration is about to occur. And yet, Harvey Gushing 4 refers to 



4 Harvey Gushing: Archives Generates de M6decine, Jan., 1901. 



