58 



EOSINOPHILIA IN BiLHARZIA DiSEASE AND DrACONTIASIS' 



Previous 

 observations 



Methods of 

 staining, 

 counting, and 

 classification 



In the Lancet of October 10th, 19(»8, p. 1009, there is an article by Captain S. R. 

 Douglas, I.M.S., and Major F. W. Hardy, R.A.M.C, on 50 cases of Billiarzia Disease, 

 in which they gave an account of the results obtained by them in the differential 

 leucocyte counts. Their very complete and interesting investigation was apparently 

 instigated by Coles's observations ^ on one case of billiarzia disease, in which he found 

 an increase of coarse-grained eosiuophile leucocytes. His case was that of a young 

 Englishman in whose blood he discovered 20 per cent, of these cells instead of the 

 normal 2 to 4 per cent. Hayem puts the normal at 7 per cent. With a view to 

 confirming Coles's solitary observation I proceeded in my spare time to examine the 

 blood of the few bilharzia cases I could obtain in Khartttum and Omdurman. 

 Billiarzia disease, so far as is known, is not common in the Egyptian Sudan, save 

 amongst those who have acquired the infection iu Egypt or elsewhere, and 

 owing to this and other reasons I was only able to examine three cases. 

 At the same time I thought it weU to investigate the blood condition in 

 dracontiasis. At the time I began to do so I believe no work had been accomplished 

 on this sul)ject, but while I was thus employed a paper ^ appeared by Dudgeon and 

 Child recording their results in one case of guinea-^vorm disease in an Englislunan 

 infected in India and resident in London. They found from 13"0 to 18'4 per cent, 

 of coai'se-grained eosinophiles present, and suggest that in this respect di'acontiasis 

 may occupy a position midway between trichiniasis and infections Avith other internal 

 parasites. I have notes on six cases of guinea-worm disease, and had intended 

 collecting further statistics before publishing an account of them, but as I find my 

 results confinn theirs in large measure I think it well to place them on record, 

 especially as some time must needs elapse before I can add materially to my number 

 of cases. 



Method. — In each instance I counted 500 leucocytes, and in nearly every case 

 made a double examination, one film being stained by Jenner's method and the other 

 liy the Leishman-Romanowsky. The counts were found to approximate very closely, 

 and that obtained in the better-stained fihn was taken as correct. In several 

 instances also other confirmatory counts were made. In difierentiating large 

 mononuclears from lymphocytes I followed the plan adopted by Captain Leonard 

 Rogers and classed every single unlobed nucleated corpuscle as large as, or larger 

 than, a jjolymorphonuclear as a large mononuclear. Like Captain Delany, I 

 preferred to place transitional forms imder the heading polymorphonuclears, Init 

 I see that Dudgeon and Child counted them as lymphocytes. 



' This paper originally appeared in the Lancet, 12/12/03. I .-im indebted to the Editor for kind permission 



- to re-publish it here 

 - Diseases of the Blood, Coles. 

 • Eosinophilia associated with Dracontiasis. — Journal of Tropical Medicine. 15/8/03 



