Clinical diagnosis a text-book of clinical microscopy and clinical chemistry for medical students, laboratory workers, and practitioners of medicine / by Charles Phillips Emerson.

  • Emerson Charles Phillips, 1872-1938.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Clinical diagnosis a text-book of clinical microscopy and clinical chemistry for medical students, laboratory workers, and practitioners of medicine / by Charles Phillips Emerson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    the lowest red count was 3,700,000, and in five the leucocytes above 10,000; in one case, 44,i50 (t° 100° F.). In 4 cases of cancer of the rectum the reds were scarcely reduced (lowest, 3,732,000, the rest about normal). There was a leucocytosis in two cases [13,100 and 19,750 (t° 100° F.)]. In 10 cases of cancer of the intestine 3 showed marked anae- mia; in one, reds 1,600,000; haemoglobin, 40 per cent.; leucocytes, 2500; situation, the ileum: the other had 1,780,000 reds, 28 per cent, haemoglobin, and 10,000 leucocytes; this patient was a nephritic as well: the third, reds, 1,609,000; haemoglobin, 40; leucocytes (one week before), 7500; situation, the sigmoid flexure. The other red counts were from 4,000,000 to 4,500,000, four cases; the highest, 5,348,000; but 2 of the 9 showed a leucocytosis. Our other cases of carcinomata showed no striking features, ex- cept one of the testicle, with 2,832,000 red cells and 9600 leucocytes. Cancers of the kidney show usually high leucocyte counts, even 54,000. We had no such case. Also of the thyroid (71,000), and some of bone (52,700). In sarcoma there is in general the same condition as in carcinoma, but some think that the effect on the blood is worse. We could not believe this from the study of our cases. This may be true particu- larly if the bone-marrow or the lymph-glands are especially involved; then a severe anaemia and high leucocytosis are the rule. In a case of osteosarcoma the red blood-cells were 663,400 (Hayem) ; in another case, 1,118,000; haemoglobin, 28 per cent.; leucocytes, 68,- 200. In still another case, 2,240,000; haemoglobin, 48 per cent.; and leucocytes, 54,000 (v. Limbeck's two cases). Yet other cases have counts even above 6,000,000, while still others present the appearance of a primary pernicious anaemia. The nucleated reds are said to be less numerous than in carcinoma. The haemoglobin is said to be more reduced than in other cancers, the average being about 50 per cent., with 30 per cent, not rarely, while cases even below 10 per cent, are reported. The leucocytes in cases of osteosarcoma average about 17,000. They are more constantly increased and to a greater de- gree than in cancer, the cases resembling leukaemia. Among the qual- itative changes an increase in the polymorphonuclear neutrophiles is less common than in cancer, but it may be present when there is no leu- cocytosis. This is said to have diagnostic value as against cancer. In some cases there is a large percentage of eosinophil cells, even 50 per cent., with little evidence that it is due to bone metastases. Mye- locytes are sometimes increased. The old question whether all these cells are leucocytes or free sarcoma cells recurs often, for the increase often seems due to the small mononuclears. Lues.—Lues, according to v. Limbeck, is the best illustration of