Am\priir'i9i5arm'}^^w  Agent  in  Pulmonary  Tuberculosis.  17 J 
2.  The  erythrocytes  were  reduced  in  number.  They  increased 
under  treatment,  at  least  temporarily,  irrespective  of  the  lesion. 
3.  When  marked  leucocytosis  existed,  due  to  toxaemia,  it  was 
reduced.  When  the  number  of  leucocytes  was  below  normal,  it  was 
increased  by  treatment. 
4.  The  lymphocytes  were  usually  reduced,  and  were  increased 
and  remained  so  in  those  patients  who  improved.  It  seems  probable 
that  this  increase  may  be  considered  as  a  reliable  indication  from  a 
prognostic  standpoint. 
5.  The  large  mononuclears  seem  to  follow  the  curve  of  the 
lymphocytes.  It  seems  probable  that  they  may  be  included  with  them, 
and  that  their  increase  or  decrease  may  have  a  like  significance. 
6.  No  conclusion  could  be  drawn  from  the  behavior  of  the 
transitionals,  eosinophils,  or  basophiles. 
7.  The  classification  and  grouping  of  the  polynuclear  neutro- 
philes  according  to  von  Arneth's  method  seems  to  have  some 
prognostic  value. 
To  summarize,  there  seems  to  be,  under  this  method  of  treatment 
of  pulmonary  tuberculosis,  and  temporarily  at  least,  even  in  the 
progressive  and  fatal  types  of  the  disease,  a  distinct  and  constant 
tendency  of  the  cellular  elements  of  the  blood  and  the  haemoglobin  to 
approach  their  normal  ratios,  and  especially  for  the  number  of 
erythrocytes,  lymphocytes,  and  large  mononuclears  to  be  augmented, 
and  for  the  haemoglobin  percentage  to  be  increased. 
The  most  immediate  and  noticeable  effect  of  treatment  was  relief 
of  dry,  ineffectual  cough.  In  all  cases  it  was  relieved,  and  in  many 
patients  it  was  limited  to  a  necessary  pulmonary  toilet  or  disappeared 
entirely.  This  seemed  to  be  due  to  the  effect  upon  the  sputum,  which 
was  increased  in  amount  and  rendered  more  liquid,  so  that  it  was 
raised  with  much  less  difficulty.  This  effect  seemed  to  be  attributable 
to  the  action  of  the  pinene  on  the  bronchial  mucous  membrane.  In 
all  cases  the  complicating  bronchitis  was  diminished  or  disappeared 
entirely.  While  it  is  recognized  that  it  is  not  always  a  trustworthy 
or  permanent  indication  of  improvement,  there  was  noted  a  marked 
diminution  of  tubercle  bacilli  and  the  secondary  organisms  in  the 
sputum,  and  in  some  instances  they  were  absent  in  several  successive 
examinations,  when  treatment  had  been  of  any  duration  or  continuity. 
The  temperature,  pulse,  and  respiration  of* those  patients  who 
presented  any  hope  of  improvement  were  reduced  and  steadied,  the 
curves  showing  decidedly  less  variation.    In  no  instance  was  an  ac- 
