THE LYMPHATIC PARTICIPATION IN HUMAN CUTANEOUS PHENOMENA

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Abstract
A technic is described for the demonstration of lymphatic capillaries in living skin and for their study. By means of vital dyes injected intradermally these vessels can be rendered plainly visible. They form an extraordinarily abundant anastomotic web. The least scratch, one which does not penetrate through the epidermis, gives rise to such conditions that lymphatic absorption readily takes place from the abraded surface; and so close-meshed is the lymphatic web that an intradermal injection with even the finest hypodermic needle tears some of the constituent vessels open with result that they undergo direct injection. In many individuals much of the fluid introduced at an ordinary intradermal injection, like that made in the clinic, spreads through the superficial lymphatic network, whereas in others it tends to enter the deeper lymphatics at once, the difference being due to merely physical factors determined by skin texture. Normal flow along the skin lymphatics is rapid even when the body is at rest, dye introduced into the skin of the resting forearm reaching the axilla within a few minutes. The observations make plain the fact that every intradermal injection is an intralymphatic one, often preponderantly such, while furthermore every local injection into the skin becomes within a few minutes a general one, so rapidly is the introduced material transported to the blood.

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