TRANSACTIONS OF SECTION I. 989 
discussed elsewhere in conjunction with a number of observations on peritonitis in 
man. 
Another factor in the production of leucopenia remains to be discussed—the 
action of the lymph paths. The lymph paths from the peritoneal cavity have 
received scant attention in the past: recently Starling has observed that the 
lymph vessels in the anterior mediastinum become filled with coloured material at 
remote periods after injection of similar material into the peritoneal cavity. The 
first observation of the author was made in December 1894. It was found that 
carbon particles began to reach the lymph glands, situated in the first intercostal 
space (guinea-pigs and rabbits), in eight minutes after injection. Solutions (car- 
mine, pot. ferrocyanide) pass up more rapidly, and these upper glands were filled 
in three minutes. Though absorption may take place in other regions of the 
‘peritoneal lining, and other lymph paths may be utilised, the course through 
diaphragmatic lymphatics to the vessels and glands of the anterior mediastinum, 
and so to the blood-vessels, is par ea:cellence the route of peritoneal lymph absorp- 
tion. Bacteria, and cells are carried along these paths from the peritoneal cavity. 
Bacteria have been seen in the lymph vessels of the diaphragm, and falciform 
ligament six minutes after injection. Bacteria have been found in the blood 
capillaries of the Jiver within half an hour of intra-peritoneal injection. The 
process is therefore both rapid and early. In man the same lymph paths have 
been found affected in acute and in chronic (tuberculous, malignant) peritonitis ; 
they should always be evamined in peritonitic cases. Ina case of ruptured tubal 
gestation these lymphatics were beautifully injected with blood, and could readily 
be traced into the root of the neck. 
Though microxyphil cells do not become free in the peritoneal fluid till about 
an hour after experimental injections, they begin to make invasion much earlier. 
Mm animals killed six to eight minutes after injection the capillaries of the mesen- 
tery (especially) are becoming blocked with microxycytes. These cells wander 
out of the vessels, and eventually through the peritoneal endothelium. Their 
invasion is associated with an increase in the amount of peritoneal fluid, followed 
(about sixteen to twenty hours) by diminution of fluid in recovering cases. 
The megoxyphil cells do not invade the cavity in significant numbers; they 
may be almost absent, and are variable and inconstant in numbers. 
The microxyphil cells, and macrophages, on the other hand, come in such 
Jarge numbers in all recovering cases that they must be considered of much signi- 
ficance, in the question of the battle against the microbes. 
The presence of microxycytes (and macrophages) in the peritoneal fluid is 
associated with an increase of bactericidal power of the fluid (vide Hahn’s similar 
observations with pleural fluid), apart from phagocytosis. A combination ot 
cellular and humoral theories is necessary for the explanation of the processes of 
reaction in peritoneal infection. 
The rapidity with which the lymph paths are brought into action, and with 
which intra-vascular changes commence, is an argument against a too rigid theory 
of coelomic and hzemal white corpuscles. 
There would appear to be a definite peritoneal circulation of cells and fluid 
from (especially the mesenteric) blood-vessels to the anterior mediastinal lymph- 
vessels, almost from the moment after intraperitoneal injection, until the normal 
condition has been re-established. 
The observations upon which these statements are based, were made in Pro- 
freon Cons laboratory in Vienna, and the Bacteriological Laboratory of Guy’s 
ospital. 
7. On the Agglutinating Action of Human Serum on certain Pathogenic 
Micro-organisms (particularly on the Typhoid Bacillus). By ALBERT 
S. Grinpaum, J.A., MB. (Cantabd.), MRCP. 
The serum of an animal immunised against the typhoid bacillus or other motile 
pathogenic micro-organism has a peculiar action on an emulsion (in bouillon) of 
the bacillus of the corresponding disease. If a drop of serum and a drop of 
