88 



NATURE 



[May 26, 1904 



THE TISSUE-LYMPH CIRCULATIONS 

 A FTER paying a warm tribute to the memory of his 

 -^ teacher in physiology, the late Prof. Sharpey, F.R.S., 

 the lecturer proceeded. 



I propose to submit to you the results of a study 

 on the circulation of the tissue fluid in man, or, in 

 other words, on the fluid transfers between the blood and 

 the tissues. Apart from its intrinsic physiological interest 

 this subject has important bearings on the practice 

 of medicine. 



Some of the conclusions suggested to me by this inquiry 





were so unexpected that I was naturally led to repeat my 

 observations in every department of it over and over again, 

 and to scrutinise all the facts with more than ordinary 

 diligence. More than 3000 observations have been made 

 in health and disease, but I propose in these lectures to use 

 mainly the physiological material. 



Methods and Apparatus. 



[Dr. Oliver here described the methods and apparatus 

 employed with certain improvements in the hsemocytometer, 

 hcemoglobinometer, and ha?mo- 

 dynamometer.J 



The Effect of the Ingestion of 

 Food on the Tissue-lymph 

 Circulation. 



Elsewhere ' I have shown that the 

 ingestion of food initiates an interest- 

 ing series of variations in the blood 

 and blood pressures which culminates 

 in a prolonged wave-like exudation 

 of tissue-lymph, and that this ex- 

 citation in the circulatory system 

 recurs with perfect regularity after 

 each meal. Subsequent inquiry has 

 amply confirmed this position. 



The digestive variations in the 

 blood pressure. — The ingestion uf 

 food invariably raises the arterial 

 blood pressure (Fig. i). In an hour 

 after a meal it rises 15 or even 20 

 millimetres of mercury, then it 

 begins to fall, and in from two and 

 a half to three and a half hours it 

 becomes stationary until the ne.xt 

 meal or until exercise is taken. The 

 curve of the venous pressure rises 

 and falls throughout with that of the 

 arterial pressure. It may, I think, be inferred from these 

 facts that the capillary blood pressure follows the same 

 curve after meals, for we know that this pressure is more 

 closelv related to the venous than to the arterial, and that 



if both these pressures rise or fall together we may fairly 

 assume that the capillary pressure will also rise or fall. 

 After food the pulse-rate also increases, and in an hour it 

 may have gained from eight to fifteen beats a minute. 

 When the pulse pressure gauge is applied so as to arrest 

 the pulsation of the radial artery (the finger being used 

 as the indicator), the reading becomes cardiometric, and 

 is generally increased in an hour after a meal from 15 to 

 20 millimetres of mercury. Therefore it would seem that 

 digestion very considerably stimulates the heart, augment- 

 ing the output and the contractile energy of the ventricle. 

 The essential aim of the digestive e.xcitation of the circu- 

 latory system is to raise the capillary 

 blood pressure, and according to my 

 observations this end is attained by the 

 increased activity of the cardiac muscle. 

 But it can likewise be secured by taking 

 with a meal some substance which 

 dilates the arteries and arterioles, and 

 thus lowers the arterial pressure ; then 

 the venous pressure is greatly increased, 

 and the capillary pressure must be 

 raised, being between two pressures 

 higher than the normal capillary 

 pressure. 



We may therefore infer that we may 



have a rise in the capillary pressure 



either with an increase or a decrease 



of the arterial pressure according as we 



have cardiac stimulation (as after 



meals) or vaso-dilation. 



Digestive Variations in the Blood. 



I have followed three series of alter- 



blood during digestion, namely, in the 



the 



ations 



corpuscles, in the haemoglobin, and in the specific gravity. 

 As the variations in the chromocytes and in the haemoglobin 

 are identical, they are taken together. 



Digestive variations in the corpusclrs and haemoglobin. — 

 The finger, having been subjected to the compression of the 

 rubber rings, yields blood which shows a progressive rise 

 in the percentages of the corpuscles and of the haemoglobin 

 until an hour has elapsed, when the increment amounts to 

 from 8 to 10 per cent. ; then the percentages gradually fall, 



CORPUSCLES 



■ PER CMm" PERCEi'I 



5.400000 fioa 



5300.000 

 5200000 

 5 100000 



5000000^; 



4900000 

 4800000 

 4700 000 

 4600.000 



3i HOURS 



SPECIFIC GRAVITY 

 of BLOOD 



1065 . 



1064 

 1063 

 I06Z 

 1061 

 1060 

 1059 

 1053 

 !057 



1 Abstract of the C 

 Tissue-lymph Circulal 

 Royal College of Physi 



'^ ProceCiiin^s of (I 

 October 3, 1903, p. 940 

 Climalological Society 



iver-Sharpey Lectures c 

 on, by Dr. George Oliv 

 ians of London on April ] 

 : Royal Society, June 

 and the Journal ol the 



2. — Chart showing the percentages of corpuscles pnd the specific gravity of the blood before 

 d after compression. Observations made before a meal and at frequent intervals afterwards. 



and they finally settle down to normal in from two and 

 a half to three and a half hours (Fig. 2, a). Should, how- 

 ever, the blood be derived from the finger in the ordinary 

 way (without compression), the successive readings of the 

 blood elements indicate a progressive fall in the percentages, 

 which in an hour amounts to from 6 to 8 per cent., when 

 a rise sets in and recovery is eventually established 

 (Fig. 2, b). 



Digestive variations in the specific gravity 0/ ttie blood.-— 

 The blood, as shown by compression of the finger, rises in 



Delivered before the 



1903 ; T/ie Lan 

 sh balneological ; 



NO. 1804, VOL. 70] 



