EOSINOPHILIA 231 



other leukocytes, or possibly derived from nuclei. As this blood dust or haemokonia 

 is found in a marked degree in lipaemia it may be that the particles are fat. It is 

 interesting that this lipaemia is absent after the taking of large quantities of fat in 

 cases with serious pancreatic trouble. The serum of a normal individual is rather 

 turbid after slight indulgence in butter. Pinched-off fragments of red cells may 

 also appear as possible protozoal bodies. 



LEUKOPENIA 



This is a term used to designate a reduction in the normal number 

 of leukocytes. A leukocyte count of 5000 would represent a slight 

 leukopenia; one of 2000, a marked leukopenia. In the latter stages 

 of typhoid, and in acute miliary tuberculosis, we expect a moderate 

 leukopenia. Glandular tuberculosis may give a very marked leuko- 

 penia. Tuberculous peritonitis will show moderate leukopenia or a 

 normal count. 



The leukopenia of typhoid is moderate and is often preceded in the first few days 

 by a moderate neutrophile leukocytosis. Later on we have a decided increase in the 

 lymphocytes. A marked diminution or absence of eosinophiles is so characteristic 

 that any increase in eosinophilic percentage negatives a diagnosis of typhoid. 



Paratyphoid gives a similar blood picture. 



Chronic alcoholism and chronic arsenic poisoning cause a reduction in the number 

 of the white cells. Pernicious anaemia especially the aplastic type shows a marked 

 leukopenia, as is also the case with Banti's disease. Two tropical diseases, kala-azar 

 and dengue, show a marked leukopenia, the counts often being below 2500. During 

 the apyrexial period of malaria we may have a white count of 5000. 



It has recently been claimed that a leukopenia with a coincident 

 marked reduction in the lymphocytes is characteristic of measles and 

 that this occurs several days before the Koplik spots appear. 



Kocher notes that in exophthalmic goiter the leukocyte count is considerably 

 diminished and that the polymorphonuclears are not much more than one-half the 

 usual percentage while the percentage of the lymphocytes is almost double the 

 normal. 



X-ray treatment tends to destroy leukocytes in the exposed region, especially 

 polymorphonuclears. The small lymphocytes are least affected. 



EOSINOPHILIA 



Where the eosinophiles are increased to 5%, we have a moderate 

 eosinophilia. In some cases of infection with intestinal parasites, 

 especially hook-worms, but also from other parasites, as round and 

 whip-worms, we may have an eosinophilia of 30 to 50%. In Guam, 

 among the natives, it is difficult to find an eosinophile count under 15.% 



