Histology of the Blood, Normal and Pathological

by Paul Ehrlich; Adolf Lazarus

Recently (since 1889) Uskoff has in particular published experimental work in this province of hæmatology. This has led him to see in the white blood corpuscles the developmental series of one kind of cell, and to distinguish in it, three stages: (1) "young cells," which correspond to our lymphocytes; (2) "ripe cells" (globules mûrs), large cells with fairly large and irregularly shaped nucleus, which are therefore our large mononuclear and transitional forms; (3) "old cells" (globules vieux), which represent our polynuclear cells. The eosinophil cells are completely excluded from this classification. Amongst clinicians A. Fränkel has recently gone in the same direction, and on the grounds of his experience in acute leukæmias has supported the view of Uskoff, that the lymphocytes are to be regarded as young cells, and early stages of the other leucocytes. But few authors (for instance C. S. Engel, Ribbert) have raised a protest to this mixing of all cell forms of the blood, and have held to the old classification of Ehrlich. But as it is emphatically taught in numerous medical works that all these cells are closely related, the grounds for sharply separating the lymphocytes from the bone-marrow group may here be shortly summarised, and stress laid on the great importance which this apparently purely theoretical question has for clinical observation. We shall come to most important conclusions upon this point when we consider more closely the share which the various regions of the hæmatopoietic system take in the formation of the blood, and especially of the colourless elements.

α. The Spleen.

The question whether the spleen produces white blood corpuscles has played a large part from the earliest times of hæmatology.

Endeavours were first made to investigate the participation of the spleen in the formation of the white blood corpuscles by counting the white corpuscles in the afferent and efferent vessels of the spleen. It was thought that the blood-forming power of the spleen was proved by the larger number of corpuscles in the vein as compared with the artery. The results of these enumerations however are very varying; the investigators who found a relative increase in the vein are opposed by other investigators equally reliable; and with the experience of the present day one would not lay any value on these experiments.

We must emphasise the fact, established by later researches, that after extirpation of the spleen, an enlargement of various lymphatic glands occurs. The alterations of the thyroid, which have been observed by many authors, cannot be described as constant.

Further, the blood investigations which Mosler, Robin, Winogradow, Zersas and others have carried on in animals and man after removal of the spleen must here be mentioned. These have already proved that a leucocytosis occurs after some considerable time. Prof. Kurloff carried out detailed investigations in 1888 in Ehrlich's laboratory, and carefully studied the condition of the blood after extirpation of the spleen. As the work of Prof. Kurloff has so far only appeared in Russian, his important results may be here recorded more fully. For his researches, Kurloff employed the guinea-pig, as this animal by its peculiar blood is specially suited for this purpose.

In order to give a systematic account of the results of these important investigations, we must first shortly sketch the normal histology of the blood of the guinea-pig according to Kurloff.

In the blood of the healthy guinea-pig the following elements are found.

I. Cells bearing granules.

1. Polynuclear, with pseudoeosinophil granulation. This granulation, which Ehrlich had previously found in the rabbit, is easily distinguishable from the true eosinophil, since it is much finer, and stains quite differently in eosine-aurantia-nigrosin mixtures. One principal distinction between these two forms of cells lies in the fact that, according to Kurloff, this granulation is very easily dissolved by acid, but remains unchanged in alkaline solutions; doubtless an indication that the granulation consists of a basic body soluble with difficulty, which with acids forms soluble salts. The true eosinophil granulation remains, on the other hand, quite unchanged under these conditions.