nuclear cells in this form of disease "that
the conditions of the transformation of the young forms have undergone a
disturbance." But if one assumes that the lymphocytes are young forms,
and the polynuclears their older stages, it is much nearer to the facts
to speak, not of a disturbance in lymphatic leukaemia, but of an absolute
hinderance to the ripening process. It is easy to conceive any
particular stimulus or injury bringing about an acceleration of the
normal process, that is, a premature old age, but it is equally
difficult to represent clearly to oneself conditions which retard or
completely prevent the normal ageing of the elements. The discovery of
such conditions would be really epoch-making, both for general biology,
and for therapeutics. The only escape from this dilemma would be the
assumption of a very premature death of the lymphocytes, for which
however not the smallest evidence is to be found, even in Fraenkel's
monograph. Fraenkel distinguishes the acute from the chronic forms of
leukaemia by the fact, "that in the former the newly formed elements
emigrate from their places of formation into the blood-stream with
extraordinary rapidity. Hence there is not time for further local
metamorphosis. In chronic leukaemia the emigration takes place very
probably much more slowly." This distinction is contradicted by the
facts; for =there are chronic forms of lymphatic leukaemia whose
microscopic picture is identical with that of acute leukaemia=. And hence
the starting-point of all Fraenkel's deductions is rendered insecure.

FOOTNOTES:

[14] C. S. Engel has recently proposed to call acute leucocytosis
"=lienal leucocytosis=," in analogy with the clinical idea of a lienal
leukaemia. This terminology should only be used if the polynuclear cells
did in fact arise from the spleen, an assumption which Engel himself
does not once appear to make, since he expressly warns against drawing
any conclusions from this name as to their origin. Since, however, the
acute leucocytoses, as we shall shew in the next section, are
exclusively to be referred to the bone-marrow, the term lienal
leucocytosis seems to us quite mistaken, for it must logically lead to a
conception of the origin of the leucocytes, exactly opposed to their
actual relationships.

[15] Many authors, _e.g._ Arnold, explain this double staining of the
eosinophil cells by the presence of eosinophil and mast cell granulation
side by side. That this is cer