Am.  Jour.  Pharm. 
July,  1902. 
Blood  Examination. 
349 
By  a  combination  of  these  terms  we  arrive  at  those  which  are 
commonly  used  in  expressing  pathological  findings.  In  diseased 
conditions,  besides  their  increase  in  number,  either  relative  or  abso- 
lute, myelocytes  also  appear. 
The  proportion  of  the  various  leucocytes,  according  to  Ehrlich's 
figures,  are:  Lymphocytes,  22,  25  percent.;  large  mononuclear  and 
transitional  leucocytes,  2,  4  per  cent.;  polynuclear  neutrophile  leu- 
cocyces,  70,  75  per  cent.,  and  eosinophile  leucocytes,  2,  4  per  cent. 
The  blood  plates  are  considered  to  be  the  extruded  nuclei  of  the 
red  blood  cells,  and  for  our  purpose  have  no  pathological  signifi- 
cance;  neither  has  the  blood  dust. 
The  technique  of  a  blood  examination  is  distinctly  in  the  realm 
of  the  specialist  in  pathology,  and  to  him  should  be  intrusted  the 
responsibility  of  this  important  procedure.  I  wish  to  emphasize 
markedly  that  he  alone  is  the  person  to  perform  this  work,  for  I 
truly  believe  that  the  blood  examination  as  conducted  by  the  aver- 
age practitioner  will  be  of  no  value  whatever.  Certainly  there  are 
not  more  than  25  physicians  in  Brooklyn  who  can  perform  this  task 
satisfactorily  and  upon  whose  pathological  report  any  reliance  can 
be  placed. 
Such  an  examination  should  be  conducted  by  men  who  possess 
the  necessary  knowledge,  exact  methods,  special  laboratory  facilities, 
and  above  all,  a  skill  in  their  work  that  only  comes  from  an  exten- 
sive experience,  for  certainly  no  good  would  accrue  to  our  patients 
if  we  were  to  mistake  small  particles  of  dirt  for  malarial  organisms, 
and  in  choosing  a  wrong  time  for  a  blood  examination,  report  to  the 
surgeon  a  marked  leucocytosis,  which  is  only  the  normal  result  of 
digestion. 
I  would  add,  too,  that  it  is  much  better  for  the  pathologist  to 
secure  the  specimen  himself,  and  also  that  he  be  instructed  upon 
just  what  particular  points  information  is  desired ;  whether  the 
number  of  cells — red  or  white — the  percentage  of  hemoglobin,  the 
presence  or  absence  of  micro-organisms  or  certain  serum  reactions 
which  are  now  obtained. 
The  principal  diseases  in  which  we  are  aided  in  diagnosis  by  the 
changes  in  the  red  cells  are  the  primary  and  secondary  anemias. 
In  simple  anemia  or  chlorosis  the  red  cells  are  slightly  decreased 
or  increased  in  number  and  the  hemoglobin  is  markedly  decreased. 
