Leukemia of the Foul. 19 
eosinophilic granules predominated, frequently showing mitoses ; others 
seemed to be composed exclusively of the large mononuclear. Here 
mitoses were also common. In these foci the convoluted tubules had 
either been pushed aside or had atrophied. 
Bone-marrow.—This was greatly changed. It consisted of a closely 
packed mass of white marrow cells, with complete atrophy of the fat 
and great rarity of normocytes. One or two small focal areas of 
sclerosis were present. The arteries were mostly empty. Some showed 
a little blood containing a few large mononuclears. Those marrow cells, 
which were present, both red and white, answered to their descriptions 
given under normal bone-marrow, with the exception of the large 
mononuclear myelocyte, which showed considerable variation in its 
nucleus. This was either single or multiple, round, oval, or horseshoe- 
shaped. The order of predominance had changed greatly. The large 
mononuclear myelocyte was present in far greater numbers than any 
other cell, and showed extensive mitoses. The normoblast and megalo- 
blast with mitoses followed next in frequency; then the normocyte. 
Polymorphonuclear myelocytes, those with eosinophilic rods and those 
with eosinophilic granules, had disappeared entirely. Curious is the 
fact that the mononuclear myelocyte with eosinophilic granules could 
not be demonstrated with certainty. As in the normal marrow lymph- 
ocytes, mast cells and platelets were not seen. 
Thyroids, Parathyroids, Pancreas and Adrenals.——These were not 
studied. 
SUMMARY. 
In summarizing the changes in the blood and organs, there was 
found: 
1. In the Blood—(a) A great increase in the total number of white 
blood cells. Although a total count was not made, this increase was 
evident from the appearance of the blood smears, and of the blood- 
vessels in sections. The actual proportion of white to red cells sub- 
stantiated this fact. The differential count showed a marked increase 
of the large mononuclear cell at the expense of the other white blood 
cells of the normal blood. In addition, a true myelocyte appeared in the 
circulation. Mitoses of the large mononuclear were common. (b) A 
corresponding decrease in the total number of red blood cells. These 
showed a drop in hemoglobin, variation in size and shape, basophilic 
staining of the cytoplasm, and swelling of their nuclei. Premature 
red cells, normoblasts and megaloblasts made their appearance. 
