350 The Philippine Journal of Science 1915 
is no bronchitis or pneumonia, a diminution of polymorpho- 
nuclear forms and an increase in lymphocytes are almost con- 
stantly found. This change is more marked toward the end of 
the disease when the polymorphonuclear forms may number less 
than 8 per cent and the lymphocytes as much as 86 per cent of 
the total. One finds a large number of immature lymphocytes 
recognizable by their large size and their nucleus. These forms 
resemble the myeloblasts of Nageli or the ‘““Lymphoiden Mast- 
zellen” of Tiirck. The remarkable lymphocytosis is, perhaps, 
due to the general involvement of the lymphatic glands met with 
in the disease. 
The polymorphonuclear leucocytes show the degenerative 
changes described by Schilling and Torgau. Their number 
rises immediately when lung complications arise. Eosinophiles 
may be as few as 0.25 per cent, but they do not disappear 
altogether as is the case in enteric fever. 
Tables II and III show the blood counts in typical cases. 
TABLE II.—Showing blood counts in a typical case. 












| | J. 
Poly- | | - Large 
|Total leu-| ‘>. | Lympho-| Eosino- | Mast- 
Case No. 2071. cocytes. een cytes. philes. zellen. Bee / 
| 1 | | 
| 
Per cent. | Per cent. | Per cent. | Per cent. Per cent. | 
Sixteenth day of disease ---_-------- 6, 200 14 TB | naan 5 | 
|) Tenthiday' of disease =--=2==22=—- == 10, 000 | 8 | bs) i Peet a (Ras or 6 
Seventeenth (temperature has | | 
fallen) eee ok ee eS oe 5, 250 25 | 68) (es. 2555-8. | ee 7 
Twenty-second (convalescent) _____- 4, 400 34 5S | 3 1 / 4 
! i] 
TABLE III.—Showing blood count in a typical case. 
= = ikea wa ails | Ge = at 
| | Poly- | Large 
~ Total leu- | Lympho-| Eosino- Mast- | 
Case No. 2685: cocytes. | mules | cytes. | philes. | zellen. | aaeleee 
|_| _ — 
| Per cent. | | Per cent. | Per cent. Per cent.| Per cent. 
Fourth day of disease __....-...---- 26, 300 | 32 | Gil ncaas ol pa 3 
Seventh day of disease _________-____ | 14, 400 36 59 | O20 > ae 4 
| Eleventh day of disease -_-_--------- 12, 600 27 Givinle™. Fhe | oe ee 12 
Fourteenth day of disease__--______- 11, 050 14 85 04s See 1 
Fifteenth day of disease -_______.-- | 12,380 18 77 | Uy eseerees 4 
Twentieth (temperature has fallen) _| 10, 000 28 64 | 2.0 1 5 
| 




OTHER SYMPTOMS 
There are no characteristic symptoms associated with the in- 
ternal organs. Diarrhoea is uncommon. The lungs and bronchi 
may be involved, and in fatal cases extensive bronchopneumonia 
has been found. Albuminuria may be present and in severe 
