THE SCIENCE AND ART OF PROTEAL THERAPY 197 



spontaneously the word spontaneous being of course merely 

 an expression of our ignorance in cases of pernicious anaemia 

 and leukaemia. But in the present instance, the patient had been 

 under observation and under treatment of the conventional type 

 for a long period before Proteal medication was resorted to, and 

 we are justified, I think, in feeling a certain measure of confidence 

 that the blood changes noted were the result of the administration 

 of the vegetable proteins, and not merely an accidental concomi- 

 tant of such administration. In any event, it will be of interest to 

 follow the subsequent history of the case before attempting the 

 promised interpretation of the observed phenomena. 

 Briefly summarized, the record is as follows: 

 Between the sixth and eighth day (following the record above 

 given), the patient was in the country and had no Proteal treat- 

 ment. She had departed somewhat from the established dietetic 

 regimen, among other things eating sausage. On the eighth day 

 she suffered a clinical relapse. Her head became heavy, and 

 throbbing. Her ear rang intolerable. She had no appetite. 

 Her mental condition was depressed and apprehensive. These 

 were among the symptoms that had characterized her malady all 

 along. The nausea and vomiting that had also characterized it 

 did not recur on this occasion. The blood count now showed 

 4,384,000 red corpuscles, with numerous normoblasts and free 

 microblasts, and abundant platelets. The white count had 

 advanced to 12,800, including large numbers of small lympho- 

 cytes of such diminutive size as to be recognized with difficulty 

 except under high powers of the microscope. The differential 

 count showed 15 per cent, polynuclears, 32 per cent, small lym- 

 phocytes, 8 per cent, large monocytes, and 2.6 eosinophiles. 

 Thus there was a tendency to increase in polynuclears, a very 

 marked increase of small lymphocytes, and a reduction in the 

 large mononuclears. More than half of the large mononuclears 

 were neutrophile myelocytes. 



Proteal treatment was at once reinstated, the particular protein 

 used on this occasion being an extract of rape seed (No. 42). 

 On the eleventh day the red cell count showed a marked falling 

 off, being reduced to 3,708,000. The general aspect of the red 

 cells was, however, much more satisfactory than at the outset. 

 Meantime the white cells were now 6,960. The differential 

 count was highly satisfactory, showing 50.7 polynuclears, 28.5 

 per cent, small lymphocytes, 18.5 per cent, large mononuclears, 

 and 2 per cent, eosinophiles. Of the large mononuclears, about 

 30 per cent, were typical large monocytes and 30 per cent, large 

 lymphocytes, and 40 per cent, neutrophile myelocytes. As hereto- 

 fore, the polynuclears tended to stain a rather pale light blue, 

 but the tendency to clump was not conspicuous as at the outset. 



