bout by the increase of the
lymphocytes, as is seen from the results of Crede and the table
contained in his paper. It is further remarkable that four weeks after
the operation a painful doughy swelling of the whole thyroid appeared,
which remained, with variations, for nearly four months. With the
general recovery of the patient this shrank to a small remnant. We
notice further that this very interesting swelling of the thyroid,
which doubtless stands in the closest connection with the splenectomy,
is nevertheless no constant accompaniment of this operation, as for
instance in the case of v. Beck, where it was not present.

The most recent work on extirpation of the spleen for tumours is from
Hartmann and Vasquez. As the result of their researches the authors
arrive at the following conclusions:

1. A slight post-operative increase of the red blood corpuscles and a
true acute hyperleucocytosis occur and pass rapidly away.

2. The haemoglobin equivalent of the corpuscles sinks at first but
recovers its original value by degrees.

3. 4-8 weeks afterwards a lymphocytosis of varying duration is
established.

4. Later, after many months, a moderate eosinophilia occurs.

We have ourselves been able to investigate three conclusive cases.

The first was a patient, which we were ourselves enabled to
investigate by the courtesy of Dr A. Neumann. The patient's
spleen was removed by E. Hahn on account of an echinococcus on
Feb. 5, 1895. One may well assume that before the operation the
spleen no longer discharged its normal function. On Sept. 2,
1897, we found the following numerical proportions:

Polynuclear neutrophil 76.5%,
Lymphocytes 18.4%,
Eosinophil 3.4%,
Large mononuclear 1.1%,
Mast cells 0.4%.

A condition therefore which was quite normal. In this
connection it must be mentioned that an incipient phthisis
pulmonum existed at the time, to which we must attribute an
increase of the polynuclear elements, and without which the
percentage figures of the lymphocytes and eosinophils would
perhaps have been greater.

For the knowledge of the two other cases we are indebted to the
kindness of Professor Jounescu of Bucharest. The one case was
of a man of about 40 years of age, in whom splenectomy was
undertaken on Sept. 27, 1897, for an enlarged spleen. Healing