ESTIMATION OF THE NUMBER OF LEUCOCYTES 217 



two physiological conditions associated with a moderate leuco- 

 cytosis. 



Digestion. — Under normal conditions there is a rise of 1,000 to 

 3,000 soon after a meal. This must always be remembered in 

 interpreting a leucocyte count. A figure of 12,000 obtained in 

 a patient an hour or two after a full meal does not necessarily 

 indicate disease. If possible, examine the patient when fasting. 



Pregnancy. — The figures rise gradually toward the end of 

 pregnancy, and at term may reach 15,000 or even higher. 

 Recollect this in interpreting counts in pregnancy or soon after 

 parturition. 



IV. Normal Counts (5,000 to 10,000, average 7,500) are 

 met with in a variety of conditions, but in comparatively few 

 that are attended with pyrexia. Of these the most important 

 are: 



Tuberculosis, except tuberculous meningitis (15,000 to 25,000), 

 and occasionally in tuberculous pleurisy (10,000 to 20,000). 



Typhoid fever. 



Malta fever. 



Measles. 



Malaria. 



Mumps. 



Varicella. 



Pernicious amentia. 



Chlorosis. 



Primary syphilis. 



Influenza. 



In any of these there will be leucocytosis if an inflammatory 

 complication is present. Thus, in typhoid fever with perforation 

 or pneumonia the count is raised. 



Very severe sepsis. 



V. A Lowered Count, or Leucopenia (under 5,000). — This 

 is not met with very frequently, and all the cases are included 

 under IV. The chief are typhoid fever, pernicious anamia, chlorosis, 

 influenza, malaria, and imcomplicated tuberculosis. It occurs also in 

 sepsis, and then indicates a very bad prognosis. It is also found 

 in starvation and malnutrition. 



