258 INANITION AND MALNUTRITION 



In rats on diets deficient in vitamin B, Drummond ('18) found (in the 

 "black variety of Mus norvegicus") no significant change in total or differential 

 blood counts. Cramer, Drew and Mottram ('21, '21a), however, observed a 

 marked decrease in lymphocytes (lymphopenia) in the circulating blood of 

 rats, associated with a general atrophy of lymphoid tissue throughout the body. 

 Prompt recovery occurred upon administration of vitamin B. Happ ('22) 

 concluded that although deficiency in vitamin B does not produce anemia in the 

 rat, "Diets so deficient in water soluble B as to produce polyneuritis diminish 

 leucopoietic activity and cause a severe leucopenia with a shift to the right in the 

 Arneth formula." Weitbrecht ('22) found in young rats on vitamin-free diets 

 (also deficient in iron) a tendency to anemia of chlorotic type. In all his 

 experiments there was a reduction in the number of leukocytes (especially 

 lymphocytes) , with nuclear changes in form. This lymphopenia is ascribed to a 

 general atrophy of the lymphatic apparatus. 



The blood changes in scurvy have been studied frequently, on account of the 

 hemorrhagic tendency characteristic of this disorder. In infantile scurvy, 

 Fraenkel ('06) found a simple anemia, with decreased hemoglobin and erythro- 

 cyte count, leukocytosis and appearance of nucleated red blood cells. Nobe- 

 court, Tixier and Maillet ('13-15) concluded that the anemia arises from 

 myeloid lesions, and recovery is sometimes long delayed. Hess and Fish ('14) 

 in infantile scurvy found the hemoglobin very low (35-70), although the red 

 cell count may be normal or slightly below. There is usually a leukocytosis 

 (10,000-40,000). The blood platelets vary within normal limits. Brandt ('19) 

 found the hemoglobin nearly normal, the erythrocyte and platelet count some- 

 times increased, the total and differential leukocyte count nearly normal 

 (sometimes lymphocytosis). 



In human adult scurvy, Sato and Nambu ('08) found a marked hydremic 

 anemia. In 54 cases, the hemoglobin averaged 31.8 per cent; the red cell count 

 2,409,323; leukocytes 6,856. In 19 convalescent, the hemoglobin averaged 

 50.7; erythrocytes 3,539,947; leukocytes 7,405. The differential count was 

 nearly normal; blood-platelets somewhat increased. In convalescent scorbutics, 

 Wassermann ('18) noted cases where the erythrocyte count rose to 6 or 7 

 millions; the hemoglobin to no or 120 per cent. Aschoff and Koch ('19) and 

 Bierich ('19) described the hemorrhages and histological appearances during 

 absorption of the extravasations. Comrie ('20) found secondary anemia and 

 lymphocytosis, with the following average in 50 cases; hemoglobin 55 per cent; 

 erythrocytes 4,080,000; total leukocytes, 7,510; polymorphonuclears 45 per 

 cent; large lymphocytes 20 per cent; small lymphocytes 29 per cent; mononu- 

 clears, 2 per cent; eosinophiles 4 per cent. Hausmann ('22) also made differ- 

 ential counts in scurvy, noting a reduction in the neutrophiles. Hess ('20) con- 

 cludes that in general the blood-picture in scurvy resembles that of chlorosis, with 

 hemoglobin decreased proportionately more than the number of erythrocytes. 

 The variations reported in total and differential leukocyte count may depend 

 upon various stages, degrees of severity, or complications in the cases studied. 



In experimental scurvy of the guinea pig, no marked blood changes have been 

 observed. Jackson and Moore ('16) found no appreciable leukocytosis. 



