234 NORMAL AND PATHOLOGICAL BLOOD 



Smallpox often shows a very large percentage of very characteristic large 

 nuclears. 



The leukopenia and lymphocyte increase in measles are important points in 

 differentiating it from scarlatina. 



Influenza shows a leukopenia at first, then a leukocytosis and, follow- 

 ing the fall in fever, a second lowering. 



With meningitis counts of 25,000 are not unusual, in abscess of the brain the white 

 count rarely exceeds i5,'ooo. 



Poliomyelitis and polioencephalitis give a slight leukocytosis during 

 the febrile accession. 



Erysipelas and epidemic cerebrospinal meningitis also give a leukocytosis of from 

 1 5,000 to 20,000. In malignant diseases we sometimes have a moderate leukocytosis. 

 Rogers states that in liver abscess, with a leukocytosis of 15,000 to 20,000, we have 

 only about 75 to 77% of polymorphonuclears there being also a moderate increase 

 in the percentage of large mononuclears. 



Drugs such as antipyrin may give a leukocytosis. The leukocyte increase of 

 pilocarpine is rather a lymphocytosis. Cinnamate of soda, sodium nucleate bacterin 

 injections and turpentine have been used in kala-azar to increase leukocytes. 



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 leukopenia. 

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



Young children have normally an excessive proportion of lymphocytes even to a 

 reversal of the polymorphonuclear-lymphocyte relation of adults. 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. 



In pellagra there is a moderate lymphocytosis, averaging 34% in about a normal 

 count. 



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

 lymphocytes. 



Malta fever is a disease which may show quite a lymphocyte increase, this going 

 with a reduction in polymorphonuclears. 



INCREASED LARGE MONONUCLEARS 



In tropical work we combine the large mononuclears and transitionals 

 in a differential count. They are the phagocytes of animal cells or 



