Polynuclear neutrophil 76.5%, Lymphocytes 18.4%, Eosinophil 3.4%, Large mononuclear 1.1%, Mast cells 0.4%.
A condition therefore which was quite normal. In this connection it must be mentioned that an incipient phthisis pulmonum existed at the time, to which we must attribute an increase of the polynuclear elements, and without which the percentage figures of the lymphocytes and eosinophils would perhaps have been greater.
For the knowledge of the two other cases we are indebted to the kindness of Professor Jounescu of Bucharest. The one case was of a man of about 40 years of age, in whom splenectomy was undertaken on Sept. 27, 1897, for an enlarged spleen. Healing by first intention. The white blood corpuscles were permanently increased. The proportion of white to red was 1:120 to 1:130, the average number of red was 3,000,000. Our own examination of preparations obtained some two months after the operation, shewed a distinct lymphæmia, and also a preponderance of the larger lymph cells. The eosinophil and mast cells were plainly increased. We are unable to give more exact numerical data, as the preparations sent to us were not spread with sufficient regularity.
From the second case, which was also operated upon for enlargement of the spleen, we unfortunately only obtained much damaged preparations. Nevertheless so much could with certainty be established--that there was no considerable increase of the lymphocytes. The eosinophils on the contrary were increased distinctly, the mast cells to a lesser extent. It is probable that the increase of both of the latter kinds of cell was not a consequence of the extirpation of the spleen alone, but rather the expression of the reactive changes, which had already begun before the operation, from the exclusion of the splenic function.
Cases of splenectomy of this kind are transitional to the chronic diseases of the spleen. The latter present great difficulties, for one never knows how far in the most chronic diseases the other organs are damaged or influenced by the general illness.
An increase of the lymphocytes, so long as an affection of the lymphatic glands may be excluded, should be referred to functional exclusion of the spleen.