[Notes on the anatomy of the thoracic duct. Analytical evaluation of bibliographic contributions. I].
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The results of clinical and modern immunological studies (assessment of T- and B-lymphocytes in the blood, cerebrospinal fluid and lymph) promoted the authors to operate (drainage of the thoracic lymphatic duct) on six patients with disseminated sclerosis to try to control their pathologically altered immune homeostasis. A rationale for a new type of pathogenetic therapy of progressive disseminated sclerosis which is tolerant to many therapeutic methods employed previously including immunodepression and immunostimulation is presented.
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Having studied the amount and quality of lymphocytes in the blood and lymph of 48 patients the authors have established that loss of great amount of small lymphocytes during the three-days drainage of the thoracic lymph duct was completely compensated at the expense of reserve populations. Drainage prolonged up to 5-6 days results in exhaustion of the circulating pool of small lymphocytes and changes in immune reactivity. The latter however are not followed by a sharply decreased antibacterial resistance of the organism.
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