602 EXPERIMENTS DEALING WITH 



vital action of the capillary wall and the tissue cells in controlling 

 and regulating lymph formation. 



Asher has given a wholly different explanation of these experi- 

 ments. For he has attempted to prove the view that tissue 

 activity is under all circumstances the sole cause of lymph flow, 

 and that any effect, whether on blood pressure, diffusion, or osmosis, 

 will affect lymph formation only indirectly, by altering tissue 

 activity. In order to prove this view it is necessary to prove two 

 things. Firstly, that increased lymph flow invariably accompanies 

 increased tissue activity this he has shown, as we have already 

 seen ; and secondly, that without increased cell activity there 

 never is increased lymph flow, even experimentally. In showing 

 this Asher has been much less successful, and especially in his 

 attempt to explain Heidenhain's experiments in accordance with 

 his view. 



(1) Heidenhain's first class of lymphagogues, according to Asher, 

 act by increasing the activity of the liver, just as do bile and 

 haemoglobin. He experimented with peptone, and found that it 

 causes an increased flow of bile from a permanent biliary fistula. 

 He has since stated that the result can be obtained but is less 

 constant with a temporary fistula. Ellinger has, however, shown 

 that peptone does not lead to an increased secretion of bile with 

 either a temporary or permanent fistula, but only to an emptying 

 of the gall bladder. For he found that peptone caused no in- 

 creased flow of bile after ligature of the cystic duct. He found 

 that leech extract had the same negative effect of bile secretion. 

 Bainbridge, using a temporary fistula, was also unable to confirm 

 Asher's result with peptone. He further pointed out that the 

 lymph obtained after peptone is of higher concentration than that 

 after injections of bile salts or haemoglobin, and consequently that 

 there is no reason for believing with Asher that they all act in 

 the same way. Some recent work by Kusmine throws light on the 

 mode of action of peptone, leech, and crayfish extracts. She 

 found that their injection causes profound changes in the micro- 

 scopical appearances of the liver cells, and therefore presumably 

 in their metabolism. The histological appearances of the cells 

 suggest in the main an acute degeneration. It hardly seems right 

 in the face of this to account for the increased lymph flow by saying 

 that these substances increase the activity of the liver cells, if by 

 this is meant increase in physiological activity, such as we believe 



