92 



NA TURE 



[May 26, 1904 



CORPUSCLES 



ramM" PERCENT' 



fios 



106 

 104 

 102 

 ICO 

 98 

 96 

 94 



:400 0CO 

 L300C00 

 5200 000 

 b 100000 

 5000000 

 4900 000 

 4800000 

 4700000 

 4600000 t 92 



Fir.. 



-Sche 



for after the lymph is absorbed the contractibility is 

 always found to be restored. How are the muscles 

 thus automatically renovated without food? It seems 

 highly probable that the reparative lymph exudation which 

 follows exercise is produced by the agency of chemical 

 substances generated by muscular contraction, just as the 

 digestive lymph flow is caused by exogenous lymphagogues. 

 Creatin and lactate of ammonium produce the double curve 

 of arterial pressure induced by e.\ercise and rest. 



Sleep. 



A large volume of lymph (not less than 20 per cent.) is 

 exuded into the somatic tissues during sleep. 



In sleep the arterial pressure falls very low (from 78 to 

 82 mm. Hg) and the venous pressure rises to a high point 

 (40 to 50 mm. Hg). There is complete physiological vaso- 

 motor relaxation, consequently the veins not only of the 

 somatic, but of the splanchnic area are filled with blood. The 

 splanchnic stasis is shown by the fact that when a weight 

 (a shot bag of 14 lb.) is 

 applied to the abdomen, the 

 arterial pressure is raised at 

 once from 80 to 100 mm. xig. 

 In a few minutes, however, 

 when the subject is fully 

 aw^alce, the arterial pressure 

 rises to 95 mm. Hg or so, the 

 venous pressure falls to 15 or 

 20 mm. Hg, the shot bag no 

 longer raises the arterial 

 pressure, and the effused 

 lymph of sleep, having be- 

 come absorbed, is no longer 

 apparent. 



What is nature's intent in 

 thus supplying the tissues so 

 liberally with lymph during 

 our sleeping hours? The 

 answer admits of no doubt — restoration ; and how true to 

 fact is the old proverb, "He who sleeps, dines"! For 

 during sleep nature provides the maximum amount of 

 tissue-lymph, which we only obtain intermittently after 

 meals. Can this be proved? The answer is provided by 

 the tension test. 



[Dr. Oliver here epitomised the results of a night and 

 morning record, demonstrating in figures the restorative 

 power of sleep.] 



[The effects of gases (oxygen, carbonic acid, sulphurous 

 acid, sulphuretted hydrogen, and the atmosphere of sewers), 

 of gravitation, of temperature, and of internal secretion 

 (supra-renal, thyroid) oa the tissue-lymph circulation were 

 described, and the vexed question as to whether tissue-lymph 

 is a secretion or a pressure product was discussed.] 



7s there an intermediary civciilaiion ? — The rapid removal 

 of lymph from the tissues when the muscles are at rest, for 

 example, after exercise and on awaking from sleep, suggests 

 absorption rather than transmission by the lymphatics. 

 Therefore I think there is evidence in support of a circula- 

 tion of fluid independent of the lymphatic circulation, 

 though controlled by the capillary circulation, of which it 

 may be said to be an extension. 



There is not time to discuss the forces involved. The 

 best account of them, as at present known, is that given 

 by Prof. Starling, of University College, than whom no 

 one has done more valuable work in support of Ludwig's 

 pressure theory (Schafer's " Text-book of Physiology," 

 vol. i.). Ludwig pointed out that the prime factors in the 

 effusion of lymph are filtration and diffusion. My observ- 

 ations refer only to filtration, and they suggest such a 

 scheme of the intermediary circulation as is represented 

 in Fig. 5, which shows the mechanism, as it were, for the 

 supply of pabulum to the tissues (.aa) and for the removal 

 of soluble waste from them (be). The view there 

 represented explains why the ingestion of food restores 

 the tissues at once, and long before the food itself 

 can be assimilated into the blood. The exhausted tissues 

 have not, therefore, to remain unsupplied until the food 

 becomes part of the common store of pabulum, which the 

 blood keeps ready for distribution. Each supply of food 

 may be viewed as a deposit paid to our banking account, 

 but it is not merely a deposit, for nature combines 



NO. 1804, VOL. 70] 



with it a cheque for payment ; the banker therefore is 

 compelled to reimburse at the same time that he receives, 

 so that the balance is kept fairly uniform. 



In normal subjects each effusion of tissue-lymph is inter- 

 mittent, rising out of and subsiding into an apparently 

 lymph-free state of the tissues when the capillary blood- 

 pressure (as indicated by the venous pressure) touches its 

 minimum point. Probably at such times some trace of 

 tissue fluid is actually present, but insufficient to be made 

 apparent by the ordinary use of the differential test. 



[Some practical deductions were here drawn, and new 

 remedies suggested by the inquiry were described.] 



There is much more work to be done, but meanwhile let 

 me summarise a few provisional conclusions : — 



(i) Tissue-lymph is intermittently effused, for example, 

 after the ingestion of food, during exercise, rest after 

 exercise, and during sleep. 



(2) The rapid effusion and removal of it in states of rest 

 suggest the existence of a circulation between the blood 



HOURS 



SPECIFIC GRAVITY 

 of BLOOD 



1065 

 1064 

 IC63 

 I06Z 

 1061 

 1060 

 1059 

 1058 

 I05r 



i and (bb) absorptit 



and the tissue spaces — a circulation independent of the 

 lymphatic circulation. 



(3) The apparent physiological intent of the effusion is 

 reparative, and that of its absorption to aid the removal of 

 tissue waste. 



(4) By studying the conditions which increase or decrease 

 lymph effusion, we ought to gain a clearer insight as to how 

 to control derangements of nutrition and metabolism. 



UNIVERSITY AND EDUCATIONAL 

 INTELLIGENCE. 



Mr. Hubert M. Turnbull, Magdalen College, Oxford, 

 has been elected to a Radcliffe travelling fellowship for 

 three years. 



The Rede lecture at Cambridge will be delivered on 

 June II by Dr. J. A. Ewing, F.R.S., upon " The Structure 

 of Metals." 



Dr. F. G. Donnan, lecturer in chemistry in the Royal 

 College of Science, Dublin, has been elected to the chair 

 of physical chemistry recently founded l:)y .Sir John T. 

 Brunner in the University of Liverpool. 



The British Medical Journal states that the new medical 

 laboratory of the University of Pennsylvania is to be opened 

 on June 30. Exclusive of site and equipment, the building 

 has cost nearly 140,000/. It is the first of a group of 

 buildings it is proposed to erect, which when completed 

 will, it is hoped, form the largest system of buildings 

 devoted to the teaching of medicine in the world. 



As a general result of the various movements in recent 

 years to establish a centre of veterinary education in Liver- 

 pool, it has been arranged, we learn from the Times, that 

 Prof. Williams, of the New Veterinary College, Edinburgh, 

 shall transfer his teaching centre to Liverpool and take 

 up the professorship of veterinary medicine and surgery 

 offered by the Institute of Comparative Pathology, and 

 shall act as principal or dean of the veterinary school. 

 Prof. Williams will be placed upon the same footing as 

 professors in the university, and the cost of the professor- 

 ship has been privately guaranteed for a period of years. 

 In accordance with a scheme drawn up five years ago by 



