[16] A. Fraenkel has recently reported histological investigations in
which he could demonstrate in one case true myelocytes in inflamed lymph
glands. He says (xv. _Congress f. innere Medecin_): "For some time past
I have had systematic examinations carried out by my assistant, Dr
Japha, on the granulations of the leucocytes contained in these glands
in a large number of infectious diseases, which are accompanied by acute
swelling of the lymphatic glands, such as scarlet fever, diphtheria,
typhoid. They were performed in the following way: dry cover-slip
preparations were made from the juice of the glands removed shortly
after death, and were stained in the usual way by Ehrlich's triacid
mixture. Amongst a large number of cases thus examined, it was possible
in only one case of scarlet fever--but in this beyond all doubt--to
demonstrate the presence of mononuclear cells with neutrophil
granulation." The extreme rarity of this condition supports our opinion
that the formation of neutrophil mononuclear elements cannot be regarded
as a normal function of the lymphatic glands. Polynuclear neutrophil
cells are nearly always naturally present in inflamed lymph glands, as a
product of the inflammation which has immigrated there. Every pus
preparation shews that the polynuclear neutrophil leucocytes can change
in the tissues to mononuclear, and the isolated observations of Japha
should be explained in this manner.
[17] Moreover the investigations of Roietzky are quite without
foundation, inasmuch as the tibia of the dog, upon which this author
performed his experiments, contains in all races of dogs--according to
the information very kindly given us by Prof. Schuetz--no red marrow, but
fatty marrow only, which as is well known is incapable of the smallest
haematopoietic function.
[18] We draw particular attention to the small number of eosinophil
cells, since according to Ehrlich's postulates this absence of
eosinophil cells is incompatible with the diagnosis of a leukaemia.
[19] In contrast to this lymphatic metamorphosis of the bone-marrow, in
myelogenous leukaemia a myeloid transformation of the other blood-forming
organs, especially of the lymph glands is found; a transformation
sufficiently characterised as myeloid by the presence of myelocytes,
eosinophils, and nucleated red blood corpuscles.
III. ON THE DEMONSTRATION OF THE CELL-GRANULES, AND THEIR SIGNIFICANCE.
During the last ten years a large amount of valuable work has been done
on the cell-granules from histological, biological and clinical sides.
This has particularly assisted haematology, where a number of problems
remain whose solution is only possible by the aid of a knowledge of the
granules. We must therefore consider the history, methods, and results
of this work.
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