and Laboratory Methods. 2717 



he concludes that the destruction of leucocytes can be estimated not only by the 

 uric acid outport but in the blood preparation by the number of leucocytes taking 

 the nuclear stain with neutral red. j. h. p. 



Billings and Capps. Acute myelogenous leu- Until recently all cases of acute lukasmia 

 "cxxvi:p.^375, °' ''' '''' '"'"''' ^e^e ^eg-^ded as belonging to the lym- 



phatic type of the disease. Fratnkel, 

 who made a careful study of the literature up to 1S95, did not admit the existence 

 of an acute myelogenous leukaemia. Pinkus in his article in Nothnagel's System, 

 published in 1901, was not able to record a single case. Billings and Capps 

 give the details of an undoubted case of an acute myelogenous leukaemia 

 observed by them in the analysis of seven cases collected from the literature. 

 The duration of the disease in their case was two months. The number of 

 leucocytes varied from 540,000 to 374,000 per c. mm. When first examined the 

 blood showed 30 per cent, of myelocytes and 39 per cent, of large mononuclears. 

 Later the percentage of myelocytes increased to 54. 



The onset in most of the recorded cases was sudden. Four cases had an 

 inflammation of the throat. The lymph nodes were usually somewhat swollen 

 and the spleen was always palpable, although in only two instances greatly 

 enlarged. The anaemia in every case was severe and progressive. The number 

 of leucocytes ranged from l<i,000 to 54O,0(H». The average count was much lower 

 than usually found in the chronic myelogenous leukaemia. There was difficulty 

 in separating the mononuclears and the myelocytes due to the fact that many 

 transitional cells with faint indistinct granules occurred. The myeloid cell has 

 usually an eccentrically placed nucleus which is often oval and the protoplasm is 

 frequently faintly granular. 



When the large mononuclears are associated with a considerable number of 

 myelocytes of the same size and when any of the mononuclears show indistinct 

 granules the writers believe it is safe to regard them as myeloid cells. 



In the recorded cases of acute myelogenous leukaemia the large mononuclears 

 never formed less than 15 per cent, of the leucocytes in the blood, while the 

 myelocytes varied from 6 to (iO per cent. Eosinophiles, mast-cells, and nucleated 

 red corpuscles were present in varying number in some cases and absent in 

 others. j. h. p. 



Simon. A Case of Myelogenous Leukemia Ehrlich has asserted that in every case 

 with several unusual Features (Absence of , , i i • i • 



Eosinophilic Leucocytes). Amer. Jour. Med. ^f myelogenous leukaemia there IS an 

 Sci., 125: 1903. increase of the absolute number of 



eosinophiles and this increase of eosinophiles is of great diagnostic value. This 

 doctrine of Ehrlich's has been repeatedly but unsuccessfully attacked. Simon, 

 however, reports a case in which throughout the course of the disease the eosin- 

 ophiles were absent from the blood. He could find no similar observation in 

 the literature, and he met with but one instance of leukaemia in which the total 

 number of eosinophiles was not increased. The blood picture in Simon's case 

 was remarkable in other respects. The percentage of mast cells was small, and 

 early in the disease the absolute number was low. This is interesting, in view 

 of Erlich's doctrine that the mast cells show an absolute increase in all cases of 



