Examination of the blood / by John C. Da Costa.

  • DaCosta, John C., 1871-1919.
Date:
[1906?]
Catalogue details

Licence: In copyright

Credit: Examination of the blood / by John C. Da Costa. Source: Wellcome Collection.

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    leukocytosis, and, like the latter, should be considered as symptomatic and not as pathognomonic. It is even more trustworthy than leukocy- tosis as a sign of infection, for grave toxemias which stifle leukocyte in- creases serve only to intensify iodophilia. lodophile leukocytes occur in all punflent lesions attended with pus absorption, but they are absent in walled-off abscess. They are also present with great constancy in cryp- togenic sepsis, pneumonia, and other infections; and in malignant disease, grave anemias, and severe cachexias. In enteric fever iodophilia may point to either intense infection or to hemorrhage, perforation, or other accident. In pure tuberculosis the reaction is negative. From a clinical standpoint, iodophilia suggests septic not tuberculous abscess, purulent not catarrhal appendicitis, septic not rheumatic nor tuberculous arthritis, malignant not benign tumor. Persistent iodophilia after the incision of an abscess indicates imperfect drainage; and after a pneumonic crisis, de- layed resolution or some other post-critical complication. Blood=pIaques.—(Plate I, Fig. 3.) The blood-plaques or platelets are non-nucleated globular bodies, which tend to adhere in the plasma in racemose groups. They measure 1 to 4 in diameter, and are of am- phophilic affinity, of quite obscure origin, and of wide normal numeric range—200,000 to 500,000 per cubic millimeter of blood, or even higher. Of their clinical significance little is known save that they are diminished in most of the acute fevers, in the hemorrhagic diatheses, in pernicious anemia, and in severe bums; and that they are commonly very numerous in many high-grade anemias (especially chlorosis and leukemia), as well as in most cases of pneumonia and tuberculosis. According to Cabot, a decided plaque increase favors thrombosis. Hemokonia.—These are colorless, refractive spheres of about 1 // in diameter, and endowed with active whirling (non-ameboid) motility. Hemokonia are possibly nothing more than free granules extmded from the neutrophile and eosinophile leukocytes, and may have some bearing on immunity. These so-called particles of blood dust” have no real clinical meaning, but it is known that they are especially abundant in typhus fever and hi Addison’s disease. IV. SPECIAL SURGICAL HEMATOLOGY. Abscess. An abscess from which free absorption of toxic material occurs sooner or later causes a secondary anemia, the degree of which roughly measures the vimlence of the poison. Chronicity of the lesion, low-grade resistance by the individual, and well-marked toxemia are the three factors which do the greatest damage to the hemoglobin and ery- throcytes. Neither the size nor the site of the abscess determines the grade of the associated blood deterioration, although, other things being equal, the anemia is likely to be greater in deeply seated large abscesses than in those of superficial situation and of small size. Of 305 abscesses examined at the German Hospital, 62 (20.3 per cent.) had 50 per cent, or less of hemoglobin, while 20 (6.5 per cent.) showed an erythrocyte count of 3,000,000 or lower.