28 QUATERCENTENARY STUDIES IN PATHOLOGY 



with I cc. of a killed agar emulsion of pneumococci subcutaneously at 



1 1 a.m, when the leucocyte count stood at 8,000 per c.mm. The result 



was : — 



At I p.m. 8,800 per c.mm. 



At 2*15 p.m. - - - - 5,600 It 



At 3*15 p.m. - - - - 5,060 I. 



At 4*15 p.m. - - . - 7,800 M 



At 5*15 p.m. . - - - 8,400 II 



At 6 p.m. ----- 9,800 II 



The next morning, the leucocytosis was 8,600, and on subsequent days 

 6,800, 8,900, and 8,350. The quantity of opsonin in the serum during 

 the first day when any leucocytosis present occurred (leucocytosis from 

 bacterial inoculations usually attaining a maximum in about 12 hours if 

 injected subcutaneously, and 8 hours if intravenously), there was only a 

 slight fall in the opsonin (at 4'i5 p.m.); on the following day, when 

 the leucocytes were normal in number, the opsonic index was 07 ; then 

 o*5 the day after; two days later i*i, and then on the second day after 

 that 17. Thus, in the case of a single inoculation of a bacterial irritant, 

 the leucocytosis does not run a similar inverse course to that of the 

 opsonic content. Is there then any physiological nexus between the 

 two? 



The course of leucocytosis in acute croupous pneumonia may, like 

 the opsonin course above described, be conveniently treated under 



the headings — 



1. Chill period. 



2. During the evolution of the disease. 



3. Terminal leucocytosis. 



Chill Period. — Lceper examined two cases in this stage, with the teeth 

 chattering, and found the total number of leucocytes raised to 24,000 and 

 18,000. This fact would indicate that the chill does not indicate the 

 beginning of the pneumonia, but most probably, as in the inoculation 

 above described, there was a period of hyperleucocytosis, as was some 

 time ago suspected by Werigo, who affirms that the leucocytes rush 

 in virtue of chemotaxis to the focus of infection, the haimopoietic organs 

 being simultaneously excited to send out the reinforcements necessary. 

 By this hypothesis, the hyperleucocytosis would, like the chill, interpret 



(392) 



