FALLACIES AND PUZZLES IN BLOOD EXAMINATION 115 



fragments," " pseudonucleation," "globular decolorisation," " Maragliano's endoglobular 



degeneration " or more shortly " Maraglianos" (Plate Y., figs. 4, 5 and 6). These, though 



they are found in normal blood, especially, it seems to me, in that of gerbils and small rats, 



appear to be more abundant in certain pathological conditions and so are very apt to 



be mistaken for haematozoa. I have little doubt they are responsible for some of the "Maraglianos" 



descriptions given by Drs. Foran and Breeze, as they tend to occur in acute infectious 



conditions, and, as they are found in any part of the red cells, vary in shape and sometimes 



appear to possess some kind of structure, they may be most confusing. They are not clear 



like vacuoles, and I have sometimes observed what looked like a tiny waving filament 



projecting from their centre. This is especially well seen when dark-field illumination is 



employed. Moreover, though they have no amceboid movement, they seem capable of 



changing their position in the red cells and this without any pressure upon the cover-slip 



or disturbance of the blood film. The movement appears to be due to progressing 



coagulation and consequent constriction of the protoplasm (Webster). They may be 



multiple and are round, oval and spindle-shaped. The more elongated forms are those 



which often have a little dark spot in the middle, which may be so distinct as to look 



like pigment (Plate V., fig. 5). They usually change a little in size on focussing and 



this helps to distinguish them in some measure. 



It would seem that the bodies described by Cabot as occurring in pernicious anaemia, 

 leukaemia and lead poisoning, and believed by him to be nuclear remnants, fall into 

 this class, and I expect that further observation on Cropper's bodies met with in cases 

 of fever will show that they are of a similar nature. A glance at Plates i and iii, in 

 Buchanan's book. The Blood in Health and Disease (1909), will be found helpful 

 by those to whom abnormal red cells present difficulties. Indeed, this book is very 

 useful to anyone studying blood morphology and more especially cellular degenerations. 

 Half the battle is often to know where to look for information, and British doctors in 

 the Tropics are not likely to turn to Pappenheim or to be regular subscribers to the 

 invaluable but almost too voluminous Folia Saematologica, edited by that indefatigable 

 German hsematologist. 



Still considering the unstained blood, we must not lose sight of granules from broken- Granules 

 down leucocytes which may overlie red cells and cause trouble (Plate V., fig. 7). 

 They have no amceboid movement, do not present the "ground glass" appearance, 

 and are easily differentiated by focussing, while, of course, they vary greatly in size. It 

 is a good plan, if a doubtful bodj^ is seen apparently lying in a red cell, to search the 

 plasma and see if its exact counterpart is not to be found lying free. 



While we are on the subject of red cells, it will be well to make mention of the 

 curious degeneration they may undergo, especially when the temperature is raised. The 

 changes which occur have been described and illustrated by Nuttall and Graham-Smith 

 and I have frequently observed them, especially when working with fowl's blood in a 

 thermostat and employing dark-field illumination. 



One is inclined to call these alterations in shape "the chain, dumb-bell, droplet, and "Chain. dumb- 

 filament phenomena," a term which, though clumsv, is fairly comprehensive and, I think '^"^ '^'^°P'"- 

 descriptive. A glance at Fig. 30 will take the place of a page of print, and it is phenomena" 

 unnecessary to say more, as, even in the height of a Sudan summer, I have never 

 encountered these changes in blood films examined at room temperature, at least when 

 using transmitted light, so it is very unlikely that they will trouble the ordinary observer, 

 though they are at first very puzzling to anyone working with heated blood. As NuttaU 

 and Graham-Smith point out, however, these alterations in red cells may be produced 



