An Inquiry into Some Mechanical Factors in the Production of Lymphocytosis

1. The lymph of the thoracic duct furnishes to the blood a larger proportion than is usually supposed of the lymphocytes in circulation. Gross variations in its output of such cells must affect very considerably the blood picture. 2. The quantity of lymphocytes supplied through the thoracic duct of the healthy dog remains practically constant from hour to hour, if the physiological conditions are not notably changed. Transient change in physiological conditions may alter the output of cells, but with the disappearance of this change the output tends to resume its previous rate. These facts indicate that the tissues producing lymphocytes are "set" at a rate of activity definite in the individual. 3. Muscular activity (struggle) produces a prompt increase in the output of lymphocytes through the thoracic duct. (a) This is assured by the presence of an increased number of cells per cubic millimeter of lymph, combined with an increase in the amount of lymph voided. (b) The lymphocyte-output may be tripled or quadrupled during a long-continued struggle. (c) Following prolonged struggle the output of lymphocytes is for a short time less than previous to the exertion. 4. The increased lymph-flow caused by a lymphagogue of the second class (glucose) brings with it increased output of lymphocytes through the thoracic duct. (a) The individual cubic millimeters of lymph are often poor in cells, during the rapid lymph-flow, yet the total number of elements transported is large. (b) The results with glucose support the theory of Ehrlich, that a rapidly appearing lymphocytosis may be produced through the flushing effect of increased lymph-flow. 5. A comparison of the effects of struggle with those of glucose demonstrates that in the former some factor besides increase in lymph-flow per se (Ehrlich) works to cause the large output of lymphocytes. The nature of this factor has not yet been determined. 6. The variations caused by muscular exertion and by increased lymph-flow in the number of lymphocytes coursing through the thoracic duct are so pronounced as to suggest that the total number of lymphocytes in circulation must be considerably influenced by them. Clinical findings by other observers indicate that this is true; and the clinical findings themselves become much simpler of interpretation. 7. The results in general prove the existence, reserved from circulation, of a large fund of lymphocytes, which is quickly yielded to the blood under certain physiological conditions.