The Biology of the Blood-Cells. With a Glossary of Haematological Terms

431 Pages·1913·10.353 MB·English

by  O. C. Gruner (Auth.)

THE
BIOLOGY OF THE BLOOD-CELLS
WITH A GLOSSARY OF HEMATOLOGICAL TERMS :
FOR THE USE OF PRACTITIONERS OF MEDICINE
BY
O. C. GRUNER, M.D. Lond.
Author of
"Studies in Puncture-fluids" ; "A Code-system for the Hospital Pathologist" ;
Pathologist to the Royal Victoria Hospital, and to the Maternity Hospital, Montreal
Assistant Professor of Pathology, M'Gill University, Montreal, etc. ;
Late Clinical Pathologist, General Infirmary at Leeds.
BRISTOL: JOHN WRIGHT AND SONS LTD.
LONDON: SIMPKIN, MARSHALL, HAMILTON, KENT AND CO. LTD.
TORONTO: THE MACMILLAN CO. OF CANADA LTD.
1913
JOHN WRIGHT AND SONS LTD.
PRINTERS AND PUBLISHERS, BRISTOL.
P R E F A CE
THIS work is intended to serve as a companion to any of the larger
text-books on Hematology. Special stress has been laid upon the
close relationship between changes in the blood-forming organs
and the blood picture as the clinician sees it, and also upon the
minute morphology of the various blood-cells, whether sessile or
free-floating. Above all, the attention of the student has been
directed to the fundamental unity of design which is the basis
of haemopoiesis from birth to death throughout the animal
kingdom.
The names of haematologists whose works have been consulted
appear in a special index, but the author wishes here more
particularly to acknowledge the great debt which he owes to
PAPPENHEIM, whose writings are in so many ways an inspiration.
0. C. GRUNER.
MONTREAL, October, 1913.
LIST OF COLOURED PLATES
I.—THE PRIMORDIAL BLOOD-CELL . . facing page 10
II.—THE RED BLOOD-CELL . . . 76
III.—AUTHOR'S SCHEME OF LYMPHOGENESIS . „ „ 126
IV.—MONONUCLEAR AND CERTAIN OTHER BLOOD-CELLS „ „ 134
V.—THE RELATION BETWEEN PULPAR TISSUE AND VENOUS
8
CHANNELS . . . . 15
VI.—THE LARGE MONONUCLEAR LEUCOCYTE . ,, ,, 190
VII.—PHLOGOCYTES . . . . „ „ 250
LIST OF ILLUSTRATIONS
FIG. PAGE
ι.—T.S. of Bone, showing Trabecule, Marrow Tissue, Blood-
vessels and Fat Spaces . . . facing page 2
2.—Photograph of Three Follicles and Spleen-oulo .. 2
S.—Fragments of Trabecular . . .
4.—A Single Follicle showing Germ-centre Ceils ;, 3
5.—Diagram of Structure of the Lymphoidocyte . . 8
6.—Diagram Representing Ontogeny and Phylogeny in a Cell
Series . . . . . .. 16
7.—Mast-cell Lymphoidocyte . . . . . 19
8.—Leucoblast . . . . . . . 22
9.—Rieder Cell . . . . . . . 22
10.—Leucosarcoma Cell . . . . . . 22
11.—Spermatogenesis . . . . . . 25
12.—Diagram showing contrast between Lymphoblast and Myelo-
blast . . . . . .. 32
13.—Scheme of Cell Descent . . . . . 38
14.—Leuksemic Proliferation . . . . - 39
15.—Rate of Proliferation: (a) Normal; (b) Hyperplasia . 39
16.—Diagram representing Hyperplasia, Metaplasia and Anaplasia 40
17, 18.—^Normal Bone-marrow . . . facing page 44
19.—Bone-marrow showing Erythroblastic Reaction ,, 45
20.—Pigment in Bone-marrow . . . 45
21.—Transverse Section of Primitive Blood-vessel . . 54
22.—Longitudinal Section of Primitive Blood-vessel . . 55
23.—Lymphoid Erythroblasts . . . . . 60
24.—Diagram of the Megaloblast Forms. . . . 62
25.—Schilling's Conception of a Red Cell . . . 70
26.—Platelets escaping from Red Blood-corpuscles . . 86
27.—A Demi-lune Body . . . . . . 88
28.—Blood-supply of Lymph Node . . facing page 113
29.—Malpighian Follicle in the Spleen . . „ ,, 113
30.—A View of the Arterial Supply of the Spleen „ „ 120
List of Illustrations xi
FIG. Ρ AGB
31.—Centre of Malpighian Follicle . . facing page 120
32.—Anomalous Shape of Malpighian Follicle . 121
33.—Edge of a Capillary, showing Discharge of Lymphoid Cells
from an adjacent Follicle into the Lumen facing page 121
34.—Central Part of a Lymphoid Follicle . ,, ,, 129
35.—Splenoid Metaplasia of Lymph-node . 156
36.—Transverse Section of a Pulp Cord . ,, 156
37.—Fragments of Trabeculae . . . ,, ,, 157
38.—Splenic Pulp Tissue, showing Fibrosis . ,, 157
39.—Splenic Pulp Tissue of Puppy, showing Megakaryocytes
facing page 161
40.—The Two Forms of Monocyte . . . . 1 75
41.—Diagrammatic, showing Morphological Differences between
Lymphatic Monocyte and Leucocytoid Lymphocyte . 176
42.—Phagocytosis in Lymph-channel of a Lymph-node facing page 183
43.—Splenic Tissue in a case of Death from Infection by Bacillus
Aerogenes Capsulatus . . . facing page 192
44.—Splenic Pulp in a state of Myeloid Metaplasia ,, 192
45.—Chart representing Inter-relations between Follicles and
Pulpar Tissue . . . . .. 193
46.—Graphic Record of the Cell-Formula of the Bone Marrow . 196
47.—Atrophic Marrow . . .. facing page 198
48.—Gelatinous Degeneration . . . ,, ,, 199
49.—Degeneration of Marrow Cell . . ,, ,, 199
50,51.—Marrow Film . . . . 200
52.—Diagram of Structure of the Lymphoidocyte . . 203
53.—The Promyelocyte . . . . .. 206
54.—Diagram of some of the Cells of the Myeloic Series . . 2 10
55.—Leucocytes showing Amoeboid Movement . . . 2 13
56.—Neutrophiles from a Case of Acute Pneumonia . . 214
57.—Graphic representation of Arneth's System. . . 2 15
58.—Caryorrhectic Leucocytes in an Inflammatory Area facing page 217
59.—Curves showing effect of certain Organisms on the character
of the Cells of the Exudate . . . . 2 16
60.—Chart illustrating Arneth's Method . . . . 2 19
61.—The Neutrophile Leucocyte . . . . 2 21
62.—Lymphocytes in the Breast. . . facing page 244
xii List of Illustrations
FIG. PAGE
63.—Adrenal Medulla, showing Small Round-celled Infiltration
facing page 244
64, 65.—Views in a Zone of Chronic Inflammatory Cell Infiltration
facing page 245
66.—Chronic Inflammatory Cell Infiltration in a Case of Gonor-
rhceal Salpingitis . . .. facing page 247
67.—Portion of a Capillary Wall in an Inflammatory Area in a
Case of Chronic Interstitial Appendicitis facing page 247
68.—Portion of an Intestinal Lymphoid Follicle, from a Case of
Typhoid Fever . . .. facine -base 27 λ
Λ. y IJXÎKJÎK X revu . . . ]U/isi,n,g * / j
69A & Β.—Diagrams to show the Double Action of Noxious Agents
on Tissues and Blood-forming Organs . . 280, 281
70.—Chart representing the Inter-relations between the Phlogocytes 283
71.—Steric Chemical Interchanges . . . . 2 95
72.—Splenic Pulp in a state of Myeloid Metaplasia facing page 302
73.—Splenic Tissue in a case of Acute Lymphatic Leukaemia
facing page 302
74.—Mononucleate and Binucleate Forms from the Pulp Tissue
of the Spleen in a case of Chronic Lymphatic Leukaemia
facing page 305
75—Germ-centres with well-marked Endothehoid Cells ,, 305
BIOLOGY OF THE BLOOD-CELLS
I N T R O D U C T I O N.
T
HE classical figure, devised by Huxley, of a hypothetical
Martian coming to this earth and making his investigations
into the life-history of mankind by parahuman methods, is so
significant that it should be ever present before the investigator.
We are too apt to follow the stereotyped lines of presentation of
ideas, and fail to transfer ourselves to an imaginary higher plane
V)f life, in order to study the appearances of things from a stand-
point as nearly extrahuman as is possible.
This objection applies with special force to the blood-cells.
These cells, circulating blindly through the blood-vessels at the
microscopic rate of thirty miles an hour, are usually only referred
to during that stage of their existence ; they are assiduously
enumerated, and percentages are worked out (" a white-cell
formula"), just as the number of fat globules might be estimated
in a drop of milk to ascertain its hygienic value. If we reflect that
these circulating cells must be manufactured, must pass through
various phases of life during which they linger in the byways and
alleys of the body, in order to fulfil definite purposes before they
succumb to the death common to all cells, we see that the ordinary
clinical conceptions are quite inadequate.
Let the reader imagine himself to be transported by magical
means to the centre of an absolutely new city, inhabited by beings
of a different and hitherto unknown race. How would he proceed
to find out the story of these beings ? He would not be content to
stand at the street corner or in the gateway, and collect together five
hundred of the bustling, active, hurrying toilers as they passed,
and, mingling them with a few of the indolent loungers in the
ι
2 Biology of the Blood-cells
vicinity, proceed to classify all these persons into percentages
according to their types. From a convenient vantage-ground he
would carefully note the peculiarities of each passer-by, dividing
them into as many different types as he could ; and he would not
confine himself to a short period of the day, but would observe
the different features about the people—at this time, at that ; to-
morrow ; a month hence ; by day ; by night. Furthermore, it is
not to be conceived for an instant but that he would look at the
buildings, the roads, the material transported along the streets,
and that he would feel a desire to ascertain the processes at work
within those buildings ; to see the factories ; to see where the
people came from ; where they went ; how they died ; why they
died ; and what part each played in the whole fabric of life.
It is evident, therefore, that a clear idea of the blood-cells
predicates more data than are supplied by taking a single drop of
blood, drying it, and subjecting it to a microscopic examination.
Maybe this is the only feasible procedure in a patient, but it is
not the only method by which the subject can be studied. The
structure of the blood-cell-forming organs is now sufficiently far
advanced to enable definite ideas to be maintained. A knowledge
of the structure of these blood-cell factories is all essential to a
correct appreciation of the significance of the presence of the
various changes found in blood films both in health and disease.
The Factories of the Blood-cells are of two varieties—those
which are in constant requisition, and those which are only
occasionally brought into action. The latter include the peri-
vascular tissues in every part of the body, while the former
embrace the bone-marrow, the spleen, and the lymphatic system
of formative tissues. There is a remarkable family resemblance
of structure exhibited by each and all of these tissues which can
only have one significance, namely, that the process of manufac-
ture is fundamentally the same in each case. Thus, to sketch
out the characters of each factory broadly, we have :—
In the bone-marrow, intense vascularity—a veritable angioma,
with numbers of formative cells completely filling up the inter-
vascular spaces, save where fat-cells are interpolated in numbers
varying with the degree of activity of blood-cell formation {Fig. i).
" In the bone-marrow, intense vascularity . . . with numbers of formative cells, completely filling
up the vascular spaces " (p. 2).
Fig. ι.—T.S. OF BONE, showing (a) the trabecular ; (ft) the marrow tissue ; (c) the deeply congested
blood-vessels; and (d) the fat spaces. The marrow tissue is seen to consist of densely-packed cells,
which stain deeply.
(Oc. 4, Zeiss Apochrom. 4 mm.).
" In the spleen, the microscope reveals two series of tissues—the well-known Malpighian body and
the pulp " (p. 3).
Fig. 2.—The photograph shows three follicles, which appear as darker-coloured areas. Within
each is an indication of the artery which traverses it. The remainder of the picture is formed of spleen-
pulp.
(Oc. 2, Zeiss Apochrom. 4 mm,).
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