THE SCIENCE AND ART OF PROTEAL THERAPY 211 



clinical betterment that attended the use of the Proteals in a 

 case well calculated to puzzle the therapeutist. All questions 

 of blood picture aside, the progress of the case, as viewed from 

 the patient's standpoint, has been exceedingly gratifying. Paro- 

 tid glands that constituted a conspicuous deformity have been 

 reduced to less than half the original size, ceasing to be very 

 unpleasantly noticeable; lymphatic nodules larger than hickory 

 nuts have been reduced to the vanishing point; persistent pain 

 in connection with these enlargements has totally disappeared, 

 without recurrence up to the present, and the patient's general 

 health, though never greatly impaired, has been raised to a 

 higher level of seeming vitality, while the sense of well-being 

 has naturally increased with the vanishing of pain. 



STUDYING THE BLOOD SMEAR 



I have a few additional suggestions to make as to compen- 

 satory relations of the different types of leucocytes versus the 

 army of erythrocytes ; but before going on to these, I would 

 like to call attention to certain practicalities of the study of the 

 blood smear that are highly essential if one is to gain a really 

 accurate knowledge of the actual conditions which the smear 

 is capable of revealing. This section can have no great interest 

 for any one who does not work with the microscope, but I be- 

 lieve it will be found to have genuine importance by a good 

 many observers who regard themselves as accomplished students 

 of microscopical blood conditions. Experience has taught me 

 that some very elementary considerations in the study of the 

 smear are often overlooked, and that skilful hematologists may 

 employ methods of making the differential count that necessarily 

 vitiate or invalidate their results. 



It is a not uncommon error, for example, as a good many 

 smears sent me for examination show, to use too large a drop 

 of blood, so that the smear runs off the end of the slide. Differ- 

 ential results are entirely vitiated in such a case, if, as often 

 happens, the white corpuscles have an agglutinative quality and 

 thus tend to clump at the end of the smear since, in this case, 

 the end of the smear will be altogether lacking. It is impossible, 

 in such a case, to gain more than a vague notion of the true 

 character of the differential count from the most careful exam- 

 ination of the smear. The data for an accurate accounting are 

 absolutely lacking. 



Assuming, however, that the smear is properly made, the entire 

 content of the drop placed on the slide being available for obser- 

 vation, it is still possible to examine it in such a way as to 

 draw entirely unwarranted conclusions as to the differential leu- 



