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342 THE BLOOD.
detail as to the results, but simply to state that they substantiate the
previously known observation that, during regeneration, irregularties
may occur in the relation between the quantity of haemoglobin and the
number of erythrocytes. A considerable decrease in the number of red
corpuscles also occurs in chronic anaemia and chlorosis; still in such cases
an essential decrease in the amount of haemoglobin occurs without an
essential decrease in the number of blood-corpuscles. The decrease in the
amount of haemoglobin is more characteristic of chlorosis than a decrease
in the number of red corpuscles. The opinions on the changes in the
blood in anaemia and chlorosis differ very considerably.1
A very considerable decrease in the number of red corpuscles (300,000-
400,000 in 1 c.mm.) and diminution in the amount of haemoglobin
( |
-
jfo) occurs in pernicious anaemia (Hayem, Laache, and others 2
).
On the contrary, the individual red corpuscles are larger and richer in
haemoglobin than they ordinarily are, and the number stands in an inverse
relation to the amount of haemoglobin (Hayem). Besides this the red
corpuscles often, but not always, show in pernicious anaemia remarkable
and extraordinary irregularities of form and size, which has been termed
poikilocytosis.
The number of leucocytes may, as stated above, be increased under
physiological conditions as well as after a meal rich in protein (physiological
leucocytosis). Under pathological conditions a high leucocytosis may
occur, and this is especially found in leucaemia, which is characterized
by a very great abundance of leucocytes in the blood. The number of
leucocytes is markedly increased in this disease, and indeed, not only
absolutely, but also in relation to the number of red blood-corpuscles,
which are diminished to a considerable extent in leucaemia. Leucaemic
Hood has a lower specific gravity than the ordinary blood (1035-1040),
and a paler color, as if it were mixed with pus. The reaction is alkaline,
but after death it is frequently acid, probably due to a decomposition
of lecithin, which is often considerably increased in leucaemia. Volatile
fatty acids, lactic acid, glycero-phosphoric acid, large amounts of purine
bases, and so-called Charcot’s crystals (see Semen, Chapter XII) have
also been found in leucaemic blood. The peptone (proteose) which is
found in the leucaemic blood after death, and which does not exist in
the fresh blood, is, according to Erben,3
a digestive product which is
1
Complete analyses of chlorotic blood may be found in Erben, Zeitschr. f. klin.
Med., 47.
2
Laache, Die Anamie (Christiania, 1883), which also contains the older liter-
ature. A complete chemical analysis of the blood has been made by Erben, Zeitschr.
f. klin. Med., 40.
Erben, Zeitschr. f. Heilkunde, 24, and Hofmeister’s Beitrage, 5. See also Schumm,
ibid., 4 and 5. See also footnote 3, page 342.
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