CHAPTER IX 



STATUS LYMPHATICUS AND STATUS HYPOPLASTICUS 

 A. Status Lymphaticus 



Here at the conclusion of the discussion of the suprarenal apparatus we 

 might add some remarks on the so-called status lymphaticus, because recent 

 investigations have shown that it possesses a close relation to conditions of 

 hypofunction of the chromaffin tissue. As I have already mentioned in the 

 chapter on the thymus gland, the tendency among many authors is for the 

 separation of status thymicus from status lymphaticus. The frequent co- 

 incidence of a large thymus gland and status lymphaticus can perhaps be 

 explained by the increase in the lymphoid elements in the thymus gland. 

 The great interest that clinicians and pathological anatomists have turned on 

 status lymphaticus depends on the fact that it is associated with cases of 

 sudden, quite inexplicable, death. It is the great service of A. Paltauf to 

 have recognized that here there is an underlying profound constitutional 

 alteration, which is always associated with lymphatism. 



How, now, is status lymphaticus characterized? Here it seems that I 

 must give vent to a conception that has forced itself upon me especially in the 

 study of the diseases of the ductless glands. I am forced to distinguish a 

 primary and a secondary lymphatism. The first develops in earliest youth, 

 and has on this account a profound influence on the development of the whole 

 organism. It is characterized by the following earmarks (in this I follow the 

 description of A. Paltauf and especially the new excellent description by 

 Kolisko). Under normal circumstances we find that in childhood the lym- 

 phatic apparatus is essentially more strongly developed than in adults. 

 Hence it comes about that the leucocytic formula of the child shows a greater 

 content of lymphocytes. The years of childhood are those in which lymphat- 

 ism is especially prone to develop. The involution of the lymphatic appara- 

 tus follows, chiefly at puberty. In true status lymphaticus the involution of 

 an already abnormally developed lymphatic apparatus remains absent. 

 We find enlarged follicles at the base of the tongue, hyperplasia of the entire 

 pharyngeal lymphatic ring, lymphoid growth in the nose, enlargement of the 

 lymphatic glands in the neck, in the axillary and inguinal regions, hyperplasia 

 of Peyer's patches, red bone marrow, large spleen, and more or less large 

 thymus gland. Very frequently we found hypoplasia and narrowness of the 

 aorta and the whole arterial vascular tract. The heart likewise is often ab- 

 normally small, although it can also be hypertrophic. Commonly there is 



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