28l 



Typhoid Fever 



During the first week (of uncomplicated 

 cases) the leucocytes are normal. 



During the second week there is a leucopenia, 

 e.g., 2,000, and the leucopenia is in proportion to 

 the severity of the disease. 



During the third and fourth weeks the 

 leucopenia is still more marked, though also a 

 leucocytosis ma}' be found without any apparent 

 cause. 



Relative Leucocyte Values. — During the third, 

 fourth, and fifth weeks the mononuclears, large 

 and small, may reach the values of forty to sixty 

 per cent., and among these the proportion of 

 small mononuclears is very striking. 



Pneumonia 



There is very early a leucocytosis, e.g., 25,000, 

 four hours after the initial chill. The maximum 

 occurs, as a rule, just before the crisis. The 

 number may fall from a high value to normal in 

 twenty-four hours. Leucocytosis is said to bear 

 a relation to the amount of exudation (i.e., lobes 

 invqlved). 



Relative count — 



Large and small mono- 

 nuclear 2 to 4 per cent. 

 Polynuclear 90 to 95 ,, 

 Eosinophil rare. 



The Widal Reaction in Typhoid 



While we consider, it is not going too far to 

 say that typhoid and malaria can be readily dis- 

 tinguished by the leucocytic count, yet seeing that 



