196 THE PROTEOMORPHIC THEORY AND THE NEW MEDICINE 



of which conditions the Proteals exercise so direct a function 

 that here, if anywhere, their action might be said to be specific. 

 In makng this survey, however, I shall constantly have in mind 

 the thesis that the anaemias and leukaemias are, in the last analy- 

 sis, secondary conditions ; the so-called primary anaemias being, 

 in my belief, usually associated with conditions of intestinal 

 toxaemia, and being therefore inseparably linked with the other 

 conditions of disturbed protein metabolism that have all along 

 engaged our attention. The word anaemia is after all only a 

 convenient name for a condition that is a necessary precursor or 

 concomitant of all types of chronic toxaemia. For the moment, 

 however, we are to focus attention on the blood conditions them- 

 selves, and to view from a slightly new angle the effect of the 

 Proteals in dealing with these disturbed conditions. 



INTESTINAL TOXEMIA AND THE ANEMIAS AND LEUKAEMIAS 

 UNDER PROTEAL TREATMENT 



In the Monograph of December 1, 1916, I gave a brief prelim- 

 inary account of an interesting case, in which there was chronic 

 protein (intestinal) toxaemia in which the red cells had the quali- 

 tative features of pernicious anaemia, although not reduced in 

 numbers as in full development of that malady ; and in which 

 there was pronounced leucocytosis, with embryonic (ontogenetic) 

 types of cells suggesting a leukaemic tendency. 



A typical count before treatment showed 3,850,000 red cells 

 (crenated, vacuolated ; anocytosis ; poikilocytosis, pronounced 

 chromophilia ; normoblasts, megalocytes) ; very few platelets; 

 and 57,000 leucocytes, with 70.6 per cent, polynuclears (full cyto- 

 plasm, feebly granular, non-acidophile) ; 21.6 lymphocytes 

 (mostly small and very basophile) ; 5.4 per cent, large mononu- 

 clears (one-third lymphoidocytes) ; 2.6 per cent, eosinophiles. 



After six days of Proteal treatment (four doses of 4 to 8 

 minims, hypodermically into arm), red cells advanced to 5,012,000 

 in number and much less abnormal in appearance; normoblasts 

 exceedingly rare, some groups of platelets ; number of white 

 cells reduced to 5,100, with 51 per cent, polynuclears, 30.5 per 

 cent, small lymphocytes, 14 per cent, large mononuclears, 2.5 per 

 cent, eosinophiles, and 2 per cent, basophiles. Patient's general 

 condition and subjective symptoms very markedly changed for 

 the better, as might be expected. 



This case appears so remarkable, that I perhaps cannot do 

 better than to use the record of its blood modification as a text 

 to guide the brief but explicit study of this aspect of the subject. 

 Of course it is not to be overlooked that very sudden changes in 

 the blood count, and even in the quality of the cells, may occur 



