234 MORBID STATES OF THE BLOOD, ETC. 



of leucocytes to take place from the distended vessels ; or a pro- 

 liferation of the existing cells ; or a transmigration of corpus- 

 cular elements from the seat of inflammation. It is unfortunate 

 that we cannot decide which of the three views is the right one ; 

 for the settlement of this question would be most important for 

 our knowledge of the physiological function of the lymphatic 

 glands. On a j^rioi^i grounds we are tempted to believe in an 

 autochthonous proliferation of the lymph-corpuscles. We may 

 very plausibly suppose that we have before us only a quantitative 

 excess of the normal proliferative activity of the gland ; of that 

 process which satisfies the physiological requirements of the 

 blood for young elements, and whose increased activity is per- 

 haps intended to compensate for the disproportionate loss of 

 colourless cells caused by their migration from the vessels in the 

 inflamed region. But since erroneous preconceptions would in 

 this matter be peculiarly hurtful, we must rigorously confine our- 

 selves to the most temperate statement of observed facts. 



According to Billroth (fig. 75) a section through the gland 

 (after hardening), from which the cells have been thoroughly 

 removed by pencilling (or better still, by shaking), shows a very 

 marked overgrowth of that system of soft, protoplasmic, stellate 

 corpuscles which is stretched out between the walls of the lymph- 

 sinus. The cells swell up in due form, they anastomose more 

 freely with one another, their processes grow thicker, and the 

 nodal points more numerous. A luxuriant proliferation of the 

 nuclei accompanies these changes, so that we finally get the ap- 

 pearance of multinuclear giant-cells, connected with one another 

 by broad anastomoses. The reticulum in the interior of the lym- 

 phatic cords and nodules (Lymphstrange und Lymphkolben) 

 remains at first quite passive in presence of the comparative 

 abundance of the infiltrated cells. A large number of its finer 

 threads are torn across, and the whole tissue comes to consist of 

 only a limited number of main trabecular, which seem to be rather 

 stouter than usual. It is only when the swelling takes place 

 very gradually that all the trabeculae of the reticulum undergo a 

 reactive overgrowth ; of this I shall say more anon. As the 

 reticulum disappears the lymph-corpuscles form globular aggre- 

 gates of larger size. Such aggregates exist here and there even 

 in the normal lymphatic nodules ; now however they per- 

 meate the whole of the glandular parenchyma. These globular 



