176  New  Agent  in  Pulmonary  Tuberculosis.  {Am-A^*-^rm- 
1.  In  pulmonary  tuberculosis,  without  cavity  formation,  a  mild 
anaemia,  with  a  decrease  in  erythrocytes  and  a  relatively  greater 
decrease  in  haemoglobin,  is  constant. 
2.  From  the  standpoint  of  prognosis,  an  increase  of  the  erythro- 
cytes, in  cases  without  cavity  formation,  is  of  favorable  significance. 
3.  In  advanced  cases  a  decrease  of  the  leucocytes  is  of  unfavorable 
import.  # 
4.  In  our  investigations  we  have  received  the  impression  that 
the  actual  increase  of  lymphocytes  seems  to  correspond  to  the  in- 
crease of  resistance  on  the  part  of  the  organism  to  the  tuberculous 
infection,  but  further  study  is  required  to  confirm  this  deduction. 
5.  The  transitionals  seem  to  follow  the  same  rule  as  the  lympho- 
cytes in  this  regard. 
6.  At  the  beginning  of  the  investigation  the  eosinophils  seemed 
to  increase  with  the  patient's  improvement,  but  further  study  did  not 
support  this  view. 
Curry,  in  studying  the  effect  of  altitude  upon  the  blood,  found  in 
normal  and  tuberculous  individuals  an  increase  in  red  and  white 
corpuscles,  but  notes  little  variation  in  the  different  kinds  of  leuco- 
cytes, while  Webb  and  Williams  have  shown  an  increase  in  the 
proportion  of  the  mononuclear  cells  in  normal  persons,  and  in  cured, 
stationary,  and  improving  tuberculosis.  That  under  various  forms 
of  treatment  the  blood  findings  correspond  closely  with  those  of 
Ullom  and  Craig  has  been  shown  by  Solis-Cohen  and  Strickler,  who 
from  182  blood  counts  of  fifty  tuberculous  patients  treated  with 
Bier's  hyperaemia,  blisters,  iodoform,  creosote  carbonate,  and  nuclein 
observe  that  there  is  an  increase  in  the  proportion  of  lymphocytes 
and  of  polynuclear  cells  with  one  or  two  nuclei.  These  investigators 
have  previously  reported  that  the  percentage  of  lymphocytes  was 
increased  in  incipient,  moderately  advanced,  and  improving  cases, 
and  that  the  percentage  of  large  mononuclears  and  transitional  cells, 
while  within  normal  limits,  was  greatest  in  incipient  and  improving 
cases. 
The  findings  of  my  own  series  of  cases  of  twenty-one  patients 
are  largely  in  accord  with  these  observations  and  seem  to  indicate 
that : 
1.  The  percentage  of  haemoglobin  (Tallquist  scale,  controlled  by 
von  Fleishl  or  Dare  haemoglobinometer)  was  reduced.  It  was  in- 
creased under  treatment.  This  increase  did  not  seem  to  depend 
upon  the  administration  of  iron. 
