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conditions, (i) in those cases where quinine has been 
taken, (2) where consequently the diagnosis is uncertain 
and the question of typhoid fever, etc., arises. 
Trypanosomiasis 
An increase in the large mononuclears has been 
found in human trypanosomiasis, but it would appear 
as if an increase in the lymphocytes were the character¬ 
istic change in sleeping sickness. The possibility of 
this should, therefore, be excluded by gland puncture. 
Typhoid Fever 
During the first week (of uncomplicated cases) 
the leucocytes are normal. 
During the second week there is a leucopenia , 
e.g . 9 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 may 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 . 9 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 involved). 
