232 CLINICAL BACTERIOLOGY AND HiEMATOLOGY 



if the count is made whilst suppuration is in progress. The sterile 

 collections of pus left after an attack of gonorrhceal salpingitis 

 do not cause leucocytosis. A normal count, therefore, does not 

 exclude pus in the tubes. Similarly, there are exceptions to the 

 rule that simple ovarian tumours and cysts are associated with 

 normal blood. Where there is inflammation and formation of 

 adhesions there is slight leucocytosis, where there is much peri- 

 toneal irritation a higher one, and with twisting of the pedicle 

 very high figures may be reached. These latter are liable to be 

 mistaken for acute peritonitis, but the leucocytes do not give the 

 iodine reaction. Further, malignant ovarian tumours usually cause 

 a slight leucocytosis and decrease of reds ; this has been suggested 

 as of diagnostic importance, but it might be due to so many other 

 conditions that not much reliance can be placed on it. A normal 

 condition of the blood, however, would be some evidence against 

 malignancy. In tubal gestation the blood is normal. After rupture 

 there is anaemia and increase of the leucocytes, which may reach 

 24,000 or more. 



Pemphigus, Dermatitis Herpetiformis, and Erythema 

 Multiforme, are associated with a high percentage of eosino- 

 philes, and this is of importance in the diagnosis of these diseases 

 from local infective processes, which they often closely resemble. 

 The eosinophiles in the former group of diseases may be expected 

 to exceed 10 per cent., and may be much higher, and there may 

 be a high leucocytosis. 



