The human spleen shows a decrease in volume of around 40% early during vigorous exercise and in response to other stressful stimuli such as maximal apnoea and the breathing of hypoxic gas mixtures. Contraction seems an active response, mediated by alpha-adrenergic fibres in the splenic nerve. Given the relatively small size of the human spleen, the effect upon physical performance is likely to be small; the augmentation of total blood volume is <2%, and even taking account of other causes of haemoconcentration during vigorous exercise, the increase of haematocrit is <10%. However, one of two studies suggested that the haemoconcentration may be sufficient to cause errors in the traditional method for calculating exercise-induced changes of plasma volume. The spleen also contributes leucocytes and platelets to the general circulation as part of the "fight or flight" reaction to stressors. The mobilisation of leucocytes proceeds more slowly than that of the red cells; it depends not only upon an active contraction of the spleen, but also a modulation of leucocyte adhesion molecules. Splenectomy impairs exercise performance in horses, but human performance data are lacking; overall health effects seem minimal, and many patients live many years after removal of their spleens.