1907.] Fatty Degeneration of the Blood. 437 



Two such would certainly be diphtheria and pernicious anaemia. In both 

 these diseases, however, we have found the leucocytes laden with fine 

 granules, which, though deeply stained, do not exhibit the transparency and 

 proper red colour of ordinary fat. 



We may first give a list of the cases in which these deep brown granules 

 occurred; the phenomenon itself we may call, for convenience, Scharlach 

 granulation : — 



Subphrenic abscess. Diphtheria (6 cases). 



Exophthalmic goitre. Appendicitis. 



Pneumonia and empyema. Pericarditis (rheumatic). 



Pernicious anaemia. Acute meningitis. 



In discussing the nature of these granules, various possibilities require 

 consideration. That the granulation is not a mere precipitate of Scharlach 

 within the cytoplasm of cells that have been imperfectly fixed is shown by 

 the fact that the diphtheria blood films (in which, amongst others, it occurred) 

 were fixed in formol vapour for over 24 hours. 



It is noteworthy that the normal granules of the eosinophile leucocytes 

 exhibit a somewhat similar coloration, though of a less intense degree. 

 Against the identity of the granulation with the substance composing the 

 eosinophile grains, however, must be placed the circumstance that the latter 

 are equally well coloured in both pathological and normal blood films after 

 the films have been treated with absolute alcohol ; the fine granules under 

 discussion, on the contrary, are not demonstrable by means of Scharlach if the 

 films are first treated with absolute alcohol. 



The degree of Scharlach granulation, moreover, present in some cases 

 (every finely granular leucocyte being laden) excludes, we think, the explana- 

 tion that the granules in question are eosinophile, which have been discharged 

 from coarsely granular cells, disintegrated, and subsequently ingested by the 

 finely granular leucocytes. 



In this connection it may be further mentioned that no eosinophilia has 

 been present in any of the cases as a possible source of such an excessive 

 amount of Scharlach-staining substance. 



The Scharlach granulation is not due to the coloration of the proper 

 granules of the cell ; for in some of the leucocytes comparatively few granules 

 occur, and in these cells the proper granules are recognisable, though 

 unstained. 



The granulation is not unlike the glycogenic, as displayed in the leucocytes 

 after treatment of blood films with iodine solution. In most cases the iodine 

 reaction takes the form of a diffuse brown coloration of the cytoplasm of the 



