208 THE PROTEOMORPHIC THEORY AND THE NEW MEDICINE 



meantime, tended to take a coppery stain. Many of them were 

 conspicuously vacuolated, and a few showed faint neuclei. 



But whereas the mononuclear leucocytes of these two very 

 distinct types sprinkled every field of the microscope so thickly 

 as almost to compete with the red corpuscles, it was necessary to 

 search across a large number of fields in succession before finding 

 a single polynuclear. Now and again, however, one did appear ; 

 and the character of this rare exhibit was altogether unequivocal. 

 The nucleus was usually of bizarre type, but distinct and clearly 

 defined ; and there was a normal quantity of clear cytoplasm. In 

 running clear across the smear, one might come upon a single 

 polynuclear, or two or three at most ; but at the very end of the 

 smear, in a dense windrow, one might find a mass of cells many 

 of which had the appearance of being degenerated polynuclears. 

 Their structure, to be sure, was ill defined ; their seemingly 

 nuclei were jumbled and as it were compacted; and they were 

 crowded together in such fashion that no trace of distinct cyto- 

 plasm remained. These cells took the stain faintly, like the large 

 monocytes already referred to ; yet they showed traces of nuclear 

 structure not to be seen in the large monocyte, and one felt that 

 they were of a different type. These cells did not appear in the 

 earlier smears ; and I am led to question whether perhaps their 

 presence suggests a tendency to restocking of the blood with the 

 hitherto minimized neutrophiles. 



It is further notable that in the most recent smear I detected 

 a single gigantic eosinophile, with three discrete nuclei, the cyto- 

 plasm abundant and sharply defined, and taking a brick-red color, 

 the individual granules very small. In this most recent smear, 

 also, there appeared to be larger numbers of large monocytes 

 that show a fairly distinct nucleus differentiated from the cyto- 

 plasm. The total number of the large monocytes, as contrasted 

 with the lymphocytes, has also conspicuously increased. In a 

 single field of the microscope, for example, using the 1.9 milli- 

 meter objective and Number 10 eyepiece, and further minimizing 

 the field by lengthening the tube, the count showed fifteen small 

 lymphocytes and twenty-one large monocytes, with not far from 

 one hundred red corpuscles. Another field showed only eight 

 small lymphocytes and twenty-three large monocytes. Such a 

 preponderance, however, was unusual ; and fields could be found 

 where the relative numbers were reversed. Thirty fields in suc- 

 cession revealed only a single polynuclear. 



The total leucocyte count at this time is 1,048,000, as against 

 a red-cell count of 2,324,000. Yet it is an astonishing fact that 

 this patient, aside from the still noticeable enlargements at the 

 sides of the neck (which, however, are no longer extremely con- 

 spicuous), might readily pass under fairly close inspection as a 



