Anæmia. Pt. 1, vol. 1, Normal and pathological histology of the blood / by P. Ehrlich and A. Lazarus ; translated from the German by H.W. Armit.

  • Paul Ehrlich
Date:
1910
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Licence: In copyright

Credit: Anæmia. Pt. 1, vol. 1, Normal and pathological histology of the blood / by P. Ehrlich and A. Lazarus ; translated from the German by H.W. Armit. Source: Wellcome Collection.

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    number of segments of the nucleus, and termed the condition, wlien the segments were less numerous than normal, as a “ sinistral asymmetry.”1 Arneth’s conclusions are very far reaching, not only witli regard to diagnosis but also with regard to prognosis, treatment, and some aspects of the doctrine of immunity. Up to the present, both confirmatory and adverse criticisms have been expressed. Arneth attempted to disprove the latter, some of which, it must be admitted, are very weak. In the first place, it must be admitted tliat the young elements show indistinct lobulation of the nucleus, and that it is extremely difficult to classify them : two competent observers may differ as to the number of segments. The more marked the nuclear staining is, the greater will be the difficulty in dividing them into individual classes. The author has often been unable to arrive at any definite conelusion in a large percentage of cells, especially when he has employed Giemsa staining. Quite apart from the fact that some observers have included large mononuclears and transition forms in the first and second classes, actual difficulties in the determinations arise for the following reasons. In the first place, for example, bisegmented nuclear forms may be closely connected with myelocytes, as Arneth supposes, but in the case of more segments being present in the nuclei it is difficult to prove such a regulär stage series in the development as Arneth’s Classification assumes. In the next place, there are undoubtedly otlier possibilities which miglit produce an apparent simplification of the lobulation of the nuclei. It is by no means uncommon for pathological leucocytes to appear in the blood, possessing but slightly lobulated nuclei, which do not belong to the early stages of the developmental series. The segment in these cases are small and stain darkly, are blotchy or swollen, and do not possess the delicate lightly stained chromatin network of young elements. ] The term “Verschiebung nach links” lias not yet, as far as the translator is aware, beeil translated into English. After consultation witli hsematologists and inathematicians, the term “sinistral asymmetry” has been deeided upou.