猩紅熱好酸球増多症を中心として見たるThorn現象の解析に關する研究

第1報 猩紅熱各病期に於けるアドレナリン注射後の白血球各分劃の變動について

抄録

1) Thorn's test through adrenalin injection was executed on scarlet fever patients at several stages of the disease. The fluctuation in the differential leukocyte count was summarized as follows:
i) Evident eosinophilic leukocytosis was observed immediately after the adrenalin injection during the febrile period of scarlet fever. The increase rate was higher in patients than in healthy persons. This initial increase in eosinophils was then followed by a temporary decrease, which was likewise demonstrated in healthy persons as well as in scarlet fever patients. In the former the decrease continued to progress even 2 hours after the adrenalin injection, and the eosinophil count after 4 hours still exhibited a reduction of 50% of the original value. At the febrile stage of scarlet fever, on the contrary, the reduction ceased to proceed already 2 hours after the injection, and the eosinophil count returned after 4 hours to the value observed prior to the injection.
ii) Lymphocytes showed an analogous fluctuation with slightly deviated phase in development.
iii) The fluctuation of neutrophils was less remarkable in febrile scarlet fever patients than in healthy persons. Monocyte count exhibited a tendency of decrease both in patients and healthy persons. The difference in both groups demonstrated a broader range of deviation in individual values in patients.
2) The results of the differential leukocyte count described above support the concept, that the mechanism of Thorn's test consists in a retention of leukocytes in organs. In scarlet fever, one of those diseases to which eosinophilic leukocytosis is characterstic, the organs partaking in the leukocyte retention are assumed to be in a condition, hypersaturated with eosinophils. Adrenalin stimulates the organs through the innervation to discharge eosinophils into blood stream. The velocity of re-retention must be the same both in patients and in hearty persons, so far as the organs concerned are not damaged in their function. A condition of hypersaturation is reached, therefore, earlier in the organs of scarlet fever patients than in those of healthy persons. This is the reason why the value of eosinophils in scarlet fever ceases to fall and begins to return to the former value already at the time (2 hours after adrenal in injection), when it still continues to decrease in healthy persons. This assumption explains at the same time the reduction in lymphocytes at the febrile stage of scarlet fever.
3) Accordingly, it is concluded that the eosinophilic leukocytosis in scarlet fever is attributable neither to a hypofunction of the hypophyseo-adrenocortical system, nor to an inability of organs to retain eosinophils.