DESCRIPTION OF PLATE II. 



All the Specimens are Stained with Eosin and Methylene-Azure. 



FIG. 1. NORMAL BLOOD. The red cells are nearly uniform in size and shape. The haemoglobin is 

 fairly evenly distributed, but is slightly more dense near the periphery than at the centre, especially in 

 those cells which have dried slowly. In rapidly dried red cells the stain is even throughout. To the left Is 

 :i lymphocyte with reddish, deeply stained nucleus iinil ;i pale bluish eell bndy. which is narrow in propor- 

 tion to the sixe of the nucleus. To the right is a small lymphocyte, smaller than the red cells which sur- 

 round it, with a deeply stained nucleus and a narrow cell body from which projects a small mass of proto- 

 plasm. At the upper portion of the figure is a large oval cell which corresponds to the large mononuclear 

 cell of Ehrlich, but considered by many equivalent to a large lymphocyte. In the centre of the drawing is 

 a cell with a lobed nucleus and purplish granules by which this basophile cell is distinguished from the neu- 

 trophile just below it and from the, eosinophije in the right lower quadrant. Two neutrophile cells are 

 shown, one with abundant tine granules, the other showing a smaller number; both types being abun- 

 dantly present in normal blood. To thejjglit is a small cluster of blood plates, some of which show darker 

 staining masses near the centre which are presumed by some observers to be nuclear remains, by others to 

 be fragments of haemoglobin. The eosinophile cell in the lower right-hand quadrant is distinguished from 

 the neutropliile by the coarseness of its granules, which are shot-like and quite regular in form, though not 

 all the granules are of the same size. They often take a much more brilliant red color than the iieutro- 

 philes. 



FIG. 2. CHLOROSIS. The blood was obtained from a young woman of twenty-two years, who had 

 3,000,000 red cells and 30 per cent of haemoglobin. The red cells are about of the same size as those in nor- 

 mal blood, but show a greatly diminished amount of haemoglobin to the individual cell as evidenced by the 

 much fainter staining of a number of cells in the plate which appear merely as remnants. Some of the cells 

 have assumed irregular shapes and are known as poikilocytes. In the left upper quadrant are three forms 

 which may be considered as pathological in circulating blood. Below, to the left, is a purplish-red cell 

 rather deeply stained, showing polychromatophilia. To the right of this cell and separated from it by a 

 nucleated red cell of normoblastic type is a cell showing granular degeneration. 



FIG. 3. SECONDARY ANAEMIA. The blood was obtained from a case of carcinoma of the stomach in 

 which the red cells were reduced to 1,500,000; the haemoglobin was 25 per cent; the leucocytes, 30,000. 

 The changes in the red cells are much the same as those noted in the chlorotic plate. There is marked dim- 

 inution of the haemoglobin of the red cells with poikilocytosis and also granular degeneration and poly- 

 chromatophilia. Two nucleated red cells are present, one in the upper right, the other in the lower left- 

 hand quadrant. Both show degenerative changes in the nuclei, which should not be mistaken for mitotic 

 figures. In secondary anaemia of this type the polynuclear neutrophiles are notably increased. 



FIG. 4. PERNICIOUS AN.EMIA. The blood was obtained from a case showing 400,000 red cells, 10 per 

 cent of haemoglobin, and 3,(KIO leucocytes. The striking features of the blood in this disease are the marked 

 alterations in size, shape, and staining properties of the red cells. The leucocytes are usually diminished 

 in number and show no characteristic changes, with the exception of a relative increase in the lympho- 

 cytes. The various types of deformation of the red cells are very well noted in the various poikiloeytes in 

 the sketch, some of which contain large quantities of haemoglobin, others a diminished amount. In the red 

 cells approaching more nearly to the normal form it will be immediately noted that the amount of haemo- 

 globin present as evidenced by the depth of stain is relatively large. The cell in the centre of the Held, for 

 example, stains a great deal more deeply than any normal cell. These deeply staining cells are also very 

 large and often of peculiar oval and irregular form. The so-called megaloblasts are abundantly present in 

 the blood of pernicious anaemia, in contrast to the inicrocytic type of cell usually found in the secondary 

 anaemias and in chlorosis. It is this macrocytosis with the consequent increase in the haemoglobin content 

 of each cell that gives rise to the high relative haemoglobin index of the blood of pernicious anaemia. A 

 normal-sized cell showing marked polychromatophilia is seen above ; a macrocyte with granular degenera- 

 tion is seen below it, and a normal-sized red cell with nucleus, or normoblast. In the lower left quadrant 

 is a large erythrocyte with a large nucleus with fine chromatin network. The cell body takes on a combi- 

 nation of the blue and pink of the stain; in other words, is polychromatophilic. Below it is a normal 

 lymphocyte. In the lower right quadrant are two other megaloblasts showing a slightly different morphol- 

 ogy and with an orthochromatic protoplasm ; that is, the cell body takes the eosin alone. The upper cell 

 shows a dense nucleus with thick strands of chromatin forming a network. In the lower the chromatin 

 shows no structure. 



FIG. 5. CHRONIC LYMPHATIC LEI-K.EMIA. The blood of this case showed 3,500,000 red cells. 160,000 

 leucocytes, and 50 per cent of haemoglobin. Of the leucocytes 95 per cent were lymphocytes. It will be 

 noted from the drawing that the red cells are practically normal in size and shape. The abundance and 

 variety of the lymphocytes will be noted immediately. In the upper right quadrant is a single normoblast ; 

 in the lower right quadrant of the upper part is a washed-out cell with irregular outline which is a degen- 

 erated lymphocyte. In the acute forms of lymphatic leukaemia these cells become exceedingly abundant. 



FIG. 6. MYELOGENOCS LEUKEMIA. The blood of this case showed 1,000,000 red cells, 30 per cent 

 haemoglobin, and 1,200,000 leucocytes, the exact proportions of which could not be determined on account 

 of the large number of irregular and degenerated forms, but myeini-ytps and basojjliiles were very abun- 

 dant. In the upper left quadrant can be seen an eosiaonhila myelocyte with a single oval nucleus and 

 large shot-like granules. Below it are a. jpripobhist^ with granular degeneration of the protoplasm and a 

 polymorphonuclear neutrophile with fine granules. In the lower left quadrant can be seen a large degen- 

 erated neutropliile mjwlopyte in which the granules, have .become scattered over the slide in the process of 

 spreading the blood. To the right and below the centre are a \iprmoblast with clover-leaf nucleus, a 

 oolvmornhonuclear neutrophlle and a lymphocyte, and above an eosftlBpClle myelocyte; m the upper ngnr~ 

 quadrant, beginning at the left, can be seen a small basophile cell with faintly staining nucleus: to the 

 right two myelocytes, one with deeply staining nucleus, the other somewhat fainter, both containing 

 neutrophile granules. To the right a normoblast with pyknotic nucleus, and still further to the right, a 

 so-called basket cell or degenerated myelocyte. 



