THE PRIMARY ANAEMIAS 199 



LYMPHOCYTOSIS. 



Of course, the disease in which we have the most marked lymphocy- 

 tosis is lymphatic leukaemia. 



The lymphocytosis of typhoid fever has been taken up under leuko- 

 penia. 



Whooping-cough may give a lymphocytosis of 20,000 to 30,000. 



Young children have normally an excessive proportion of lymphocytes. This 

 is apt to be particularly marked in hereditary syphilis. Enlarged tonsils may 

 give rise to a lymphocytosis of 10,000 to 15,000, when more than 50% of the white 

 cells will be lymphocytes. Rickets and scurvy give a lymphocytosis. 



Varicella and mumps may also give a a increase in the percentage of 

 lymphocytes. 



Malta fever is a disease which may show quite a mononuclear increase. 



DISEASES IN WHICH THERE is A NORMAL LEUKOCYTE COUNT. 



Uncomplicated tuberculosis, influenza, Malta fever, measles, try- 

 panosomiasis, malaria, syphilis, and chlorosis. In malaria we have 

 a leukocytosis at the time of the rigor, while during the apyrexial period 

 there is a moderate leukopenia. In malaria we have a marked increase 

 in the percentage of the large mononuclears and transitionals. These 

 may form from 25 % to 35 % of the leukocytes. When beaiing particles 

 of pigment they are known as melaniferous leukocytes macrophages 

 which have ingested malarial material. In dengue, at the time of the 

 terminal rash, we may have as great a percentage of large mononuclears. 

 In this disease, however, we have a great diminution of polymorphonu- 

 clears from the start (25 to 40%). Instead of a large mononuclear we 

 have at the onset a lymphocytic increase. There is an increase of large 

 mononuclears in trypanosomiasis. 



The white count is about normal in uncinariasis (Ashford's average 

 was 7800). Some have reported a leukopenia in severe cases. 



While eosinophilia is the most marked feature in hook-worm disease 

 yet in very severe cases it may be absent. 



THE PRIMARY ANAEMIAS. 



Chlorosis. In chlorosis it is the reduction of haemoglobin with the 

 slight numerical variation from normal of the red cells that makes for 

 a diagnosis. The color index is very low. There is nothing abnormal 



