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blood counts, well-marked laevodeviation was observed in 

 every case. In "cases still living, but all doing badly, as the 

 remarks of the Tp resent condition given herewith show, the 

 amount of laevodeviation present may be seen from the following 

 table (Table III) : 



Table III. — Showing LiEVODEViATioN in Pulmonary Tuberculosis 



Now, Arneth considers that toxaemias bring about the 

 destruction of neutrophile leucocytes, the disintegration 

 affecting particularly the older cells, so that forms possessing 

 the most divided nucleus disappear first from the blood. 

 Hence the neutrophile blood picture may be taken as an 

 index of the severity of the intoxication. 



That toxic substances circulating in the blood actually do 

 bring about the destruction of the neutrophile leucocytes 

 is proved by examination of the blood in cases of poisoning by 

 Tri-nitro-toluol and allied substances. Cases of Tri-nitro-toluol 

 poisoning occurred not infrequently in certain classes of 

 munition workers during the Great War, especially among 

 " T.N.T. Fillers." In one fatal case in which I made a differ- 

 ential leucocyte count shortly before death, the destruction 

 of the polymorphonuclears was carried to such an extreme 

 degree that none of the well-known varieties of leucocyte could 

 be detected, such leucocytes as were present consisting entirely 

 of badly staining degenerate-looking cells, somewhat resembling 

 abnormal lymphocytes. This condition of the leucocytes pro- 

 duced a striking picture of the histological appearances of the 

 blood — a peculiarity which I have never encountered in any 

 other condition. These findings are quoted to support Arneth's 

 views that toxsemic conditions bring about destruction of the 

 polymorphonuclear leucocytes, but the destructive process had 

 here been carried to such a degree that all the five varieties 

 had disappeared alike, leaving open the question whether 

 there was any difference in the order of their destruction. 



If this explanation of Arneth be correct, it appeared to me 

 that it may be assumed that the general functional activity of 

 the neutrophile leucocyte will vary with the age, and therefore 

 with the amount of nuclear segmentation presented by these 



