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its nucleus and protoplasm stain very deeply, as deep as the small lymphocyte. Since the cells are as large or larger than polymorphonuclear leucocytes they cannot be mistaken for large lymphocytes or other cells. The normal blood picture as given by various writers on hematologv, differs so markedly that one is unable to accept any one writer's percentage of leucocytes as a standard. The comparatively recent studies of Warfield (i) in Wisconsin, Miller (2) in Baltimore, and Bunting (3) in Wisconsin well il- lustrate the above, Canadian Prescription Free Cialis and give a clear survey over the literature. In a general way the following percent- ages were taken as the normal: polymorphonuclear neutrophilic leucocytes, fifty to sixty-five per cent.; polymorphonuclear basophilic leucocytes, 0.5 to 1.5 per cent. ; polymorphonuclear eosinophilic leuco- cytes, one to four per cent. ; lymphocytes, twenty to thirty per cent. ; transitionals and large mononuclear leucocytes, five to ten per cent. As to the differential leucocyte count in tubercu- losis, we have, of recent writers, the studies of Strickler and Solis-Cohen Canadian Prescription Free Cialis (4) in Philadelphia, Mar- garet Lewis in Baltimore, and Richards in Ohio. All of these counts differ as markedly as does the normal blood picture. While much of this must be attributed to the different conception of the various types of leucocytes entertained by the writers, the factor of altitude, climate, mode of living and Canadian Prescription Free Cialis the like, and the dift'erence in stains em- ployed have a great weight. -Differential Count— —Arneth Formuta- LA. n. A II. B ri. Total a. Canadian Prescription Free Cialis n. K -^ ►^ =; III. B III. Total 14.5 45 Grand 1 1. 5 99.956.02.50.524.516.522.5.14.528.513 1. 5 71.2 49-5 9S.3 65.0 1.3 0.3 22.1 1 1.6 26.7 44.6 24.0 3.80.683.3 33-3 100.5 62.0 2-5 2.0 22.6 12.9 31-7 43-3 19-3 40 0.2 86.8 41.4 99-4 639 1.9 I-l 22.3 12.2 29.244.9 21.7 3-9 0-4 850 54-8 97.7 72.5 1.43.5 12.2 13.2 54.2 36.7 7-4 0.7. ..95. 5 35.7 100.6 78.1 0.6 0.1 9.3 II. 7 54.6 36.8 8.2 0.2 ... 95.6 75-3 10 1.8 10.7 12.454.4 36.7 7.8 0.4 ...95.5 Total so 32.5 99.465 1.5 I.I 18.3 13.7 35.3 38.7 19.7 5.70.683.9 The accompanying table shows our results. The polymorphonuclear leucocytes average from fifty- six per cent, in Stage I, to sixty-three per cent, in Stage II, to seventy-five per cent, in Stage III. It must not be forgotten that secondary infections, ex- Canadian Prescription Free Cialis isting in all second and third stage cases of pulmo- nary tuberculosis influence this probably to a far greater extent than does the original disease. The basophilic and eosinophilic cells show Canadian Prescription Free Cialis no important changes. The lymphocytic picture has an inverse ratio to the percentage of polynuclear cells. With the low percentage of neutrophilic leucocytes of Stage I we have the highest percentage of lympho- cytes Canadian Prescription Free Cialis — 24.5 — in this group. In Stage II, the lym- phocytes drop to 22.3 per cent., and in Stage III to 10.7 per cent. The average for the entire group of fifty cases is 18.3 per cent. The transitional cells and large mononuclear leucocytes, while showing some variation in individual cases, average but little in the three stages. In Stage I. 16.5 per cent. ; in Stage 11, 12.2 per cent.; and in Stage III, 12.4 per cent, occur, giving an average of 13.7 per cent, of the entire group. A further, less marked varia- tion of the various cell percentages is seen in the ambulant and bed patients of .stages II and III. The variation is, however, but slight. Comparing our results with those of others we find that the regular increase in the percentage of neutrophilic leucocytes with the advance of the dis- ease agrees with the findings of other Canadian Prescription Free Cialis workers as cited by Strickler and Solis-Coheri, likewise the decrease in lymphocytes corresponds to the findings of other writers. The more the lung tissue is 494 liACHMAN AND LUCKE: BLOOD COUNT IN TUBERCULOSIS. [N'ew YotK MeOICAI. JOUtNAI. destroyed by both the tubercle bacilH and especially by the pyogenic organism of the secondary infec- tion, the smaller is the percentage of lymphocytes.