THE SPLEEN AS AN ENDOCRIN ORGAN 665 



(a) (6), Lombroso and Marietta. One of the most interesting observations 

 is that of Sweet and Ellis. They noted that the spleen becomes very small 

 after the external function of the pancreas is destroyed. We have verified 

 this observation. If it can be shown clearly that the atrophy of the spleen 

 following damage to the external function of the pancreas is not dependent 

 on the same factors that cause loss of weight to the rest of the body, an 

 important advance denoting an interglandular relationship of the spleen 

 will have been made. 



The Spleen and the Liver. One of the very early functions ascribed 

 to the spleen is the transformation of the thick and muddy juices generated 

 in the liver (Galen). Since Galen's time more or less vague hypotheses 

 have been advanced concerning an interrelationship of the spleen and liver, 

 the most definite by Black. However, this author gives to the spleen a 

 more or less mechanical function of diluting the blood which passes to the 

 liver, emphasizing of course the importance of Aristotle's observation that 

 the blood from the spleen drains into the portal circulation, and Cuvier's 

 observation that a spleen is present in all species of vertebrates. 



Pugliese was the first to study the output of bile pigment from a bile 

 fistula following splenectomy. He noted a decrease of about one-half the 

 pigment while the other constituents of the bile were but little altered. 

 Hooper and Whipple were unable to find any change in the elimination of 

 bile pigment after the removal of the spleen, although very peculiar reac- 

 tions occurred in the bile pigment of splenectomized dogs when hemorrhage 

 or other experimental complications were added to the removal of the 

 spleen. Such changes did not occur in normal dogs. Goto obtained evi- 

 dence of a decrease in the elimination of bile pigment after splenectomy 

 and concludes that the spleen influences the formation of the pigment. 



Giffin, Sanford and Szlapka have shown that the elimination of 

 urobilin and urobilinogen doe not run parallel with the excretion of bili- 

 rubin and that when the spleen is removed for pathologic conditions, par- 

 ticularly pernicious anemia and hemolytic jaundice, a very marked 

 decrease in the elimination of urobilin and urobilinogen occurs. 



Granting that the spleen exerts some influence on the elimination of 

 bile pigment, this does not necessitate that one postulate the elaboration 

 of a specific internal secretion by the spleen influencing the liver. There 

 is no doubt, as Black first pointed out, that the purely mechanical relation 

 of the spleen to the liver influences the function of the latter. This has 

 been well brought out by a series of studies on the effect of diverting the 

 splenic blood from the liver directly into the general circulation (Krumb- 

 haar, Musser and Peet, Krumbhaar and Musser, Burket). The results 

 of such experiments in general have been identical with those in which 

 the spleen was completely removed from the body, showing the possibility 

 that the spleen acts as a shunt to the portal circulation. 



Pathologic studies have long since demonstrated that the spleen and 



