INFL UENCE OF THE SPLEEN ON METABOLISM. 959 
In advanced cases of Addison's disease, with complete degeneration of the 
medulla of the suprarenale, an extract of these organs is devoid of all physio- 
logical activity. 1 Such patients show, as already stated, extreme muscular 
weakness, and very rapidly become fatigued, and their capability of raising a 
weight, as estimated by Mosso's ergograph, is extraordinarily small. In one 
such case, which was treated by exhibition of fresh capsides of the calf, the 
amelioration of this condition was found by Langlois to be very manifest. 
The above is well illustrated by the accompanying tracings — Fig. 92, A, in a 
patient with Addison's disease ; Fig. 92, B, in the same patient after six weeks' 
treatment with suprarenal capsules of the calf.'-' The tracings are not strictly 
comparable, for the second one was taken with half the weight, but on the 
other hand it has been reduced to one-half. 
Influence of the Spleen on Metabolism. 
The constant occurrence and relatively large size of this organ in 
vertebrates, the very large supply of blood which it receives, and its 
intimate anatomical relationships with the digestive organs, would seem 
to render it probable that it must have important functions to perform 
in connection with the nutrition of the body. 
Effects of removal. — This supposition is not, however, borne out by 
the result of experiment, for it has been abundantly proved that 
the spleen can be completely removed in animals and in man without 
their exhibiting any abnormal symptoms whatever. 3 
Whether the functions of the organ can be taken up under these 
circumstances by other organs, such as the lymphatic glands, is a point 
which has not yet been determined. In a dog from which I had removed 
the spleen several months previously, and which was examined for me 
with regard to this point by Swale Vincent, there appeared to be a 
larger number of haemal lymphatic glands than in normal dogs, 4 but it 
would require a long series of observations to establish this point 
conclusively. Certainly such a function as the formation of lymph 
corpuscles may well be carried on by the abundant lymphoid tissue 
which is present in other organs of the body; but the spleen has 
undoubtedly, in addition to this, a certain influence upon the haemoglobin 
of some, at least, of the blood corpuscles which are passing through its 
tissue, for we find haemoglobin in various stages of transformation into 
other kinds of pigments within the cells of the organ, and also find a 
relatively considerable amount of iron in loose organic combination. It 
has therefore been supposed that the cells of the spleen pulp may 
produce disintegration of effete red blood corpuscles, and that their 
pigment may pass to the liver, either as free haemoglobin or as formed 
bile pigment. Neither free haemoglobin 5 nor bile pigment can, how- 
ever, be detected in the blood of the splenic vein. 
On the other hand, the function of producing new red blood 
corpuscles has been ascribed to the spleen, on the grounds that 
1 Oliver and Schafer, loc. cit. 
2 For other references and observations on the connection between the suprarenals and 
Addison's disease, see H. D. Rolleston, Goulstonian Lectures, Brit. Med. Journ., London, 
1895, vol. i. ; and Langlois, " Maladie d' Addison," " Dictionnaire de physiologie de Ch. 
Richet," Paris, 1895. 
3 There is considerable literature on this subject. It has been collected by Pernet, and 
is given by him in the British Medical Journal for November 26, 1896. 
4 For an account of these organs, see Swale Vincent and Harrison, Journ. Anat. and 
Physiol., London, 1897, vol. xxi. p. 182. 
5 Schafer, "Proc. Physiol. Soc," May 1890, in Journ. Physiol., Cambridge and 
London, vol. xi. 
