350 
Blood  Examination. 
Am.  Jour.  Pharmr 
July,  1902. 
The  color  index  is  usually  low.  This  color  index  is  really  an  estima- 
tion of  the  amount  of  hemoglobin  in  each  cell  on  a  percentage  basis, 
and  is  obtained  by  dividing  the  percentage  of  hemoglobin  by  the 
percentage  of  the  red  cells  present,  5,000,000  of  the  erythrocytes 
being  considered  100  per  cent. 
Therefore,  given  a  case  with  3,000,000  red  cells  and  50  per  cent, 
of  hemoglobin,  the  color  index  would  be  -83  (found  by  dividing  50 
per  cent,  hemoglobin  by  60  per  cent,  red  cells  present),  the  normal 
color  index  being  represented  by  1. 
In  pernicious  anemia,  the  number  of  red  cells  is  markedly  reduced, 
even  to  1,000.000  or  less.  They  are  altered  in  size,  shape  and 
appearance  of  nucleated  forms,  namely,  megaloblasts,  large  nucleated 
red  cells  and  normoblasts,  or  nucleated  red  cells  of  nearly  normal 
size. 
In  the  secondary  anemias,  namely,  those  following  hemorrhages, 
acute  or  chronic  infectious  febrile  diseases,  malignant  growths,  some 
intestinal  parasites,  etc.,  the  conditions  of  the  red  cells  are  identical 
with  those  found  in  simple  and  pernicious  anemias,  varying  in  de- 
gree according  to  the  severity  of  these  secondary  causes. 
An  increase  in  the  number  of  the  white  cells  or  leucocytosis  is 
normally  present  in  the  newly  born,  during  digestion,  the  latter  part 
of  pregnancy,  after  parturition,  after  violent  exercise,  massage,  cold 
bathing  and  in  the  moribund  state. 
Pathological  leucocytoses  are  post-hemorrhagic,  inflammatory 
toxic,  those  found  in  malignant  disease,  and  those  due  to  therapeutic 
and  experimental  influence.  According  to  Cabot  we  have  the  fol- 
lowing subdivision  : 
Inflammatory. — (a)  Infectious  diseases  with  comparatively  slight 
local  inflammatory  processes :  Asiatic  cholera,  relapsing  fever, 
yellow  fever,  typhus  fever,  scarlet  fever,  bubonic  plague,  ery- 
sipelas, secondary  stage  of  syphilis,  diphtheria  and  true  follicular 
tonsillitis. 
(b)  Infectious  diseases  with  more  extensive  local  lesions  :  Pneu- 
monia, smallpox,  malignant  endocarditis,  trichinosis,  glanders, 
actinomycosis,  septicemia  and  all  conditions  that  are  the  result  of 
suppurative  inflammation. 
The  febrile  state  of  acute  multiple  neuritis  :  Acute  articular  rheu- 
matism, cerebro-spinal  meningitis,  cholangitis,  cholo-cystitis,  empy- 
ema of  gall-bladder,  acute  pancreatitis,  endometritis,  some  cases  of 
