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Related post: ary 5th (1905) eleven per cent.; patient subsequent-
ly died. Case v was very instructive ; patient had a
lymphocyte count of 33.6 per cent, and was in an
ambulant condition, but later on began to grow
worse, got weak, and was put to bed : his lympho-
c\'te count came down to twelve per cent. ; before
death his lymphocyte count increased. This pre-
lethal increase is quite prominent in a good many of
their cases, but it is not constant. I have not no-
ticed enough of it in my observations to draw any
conclusions, but this failure on my side may be due
to the fact that I did not have the control of the pa-
tients in their last moments, and therefore could
not make the majority of my counts as late as
Swann and Karsner made theirs. Of the thirty-
one cases Swann and Karsner have reported twen-
ty-nine terminated fatally, the other two did not
terminate in this manner, but these two cases liad a
good or a fairly good lymphocyte count.
THE TR.\NSITIOXALS.
In healthy subjects I found transitionals to be
present in the blood in the average of three per
cent., in tuberculous individuals the average reached
only four per cent. ; at first sight the difference is
not great, but the changes in progressing cases are Reosto Himalaya
quite noticeable. It ran up at times to fifteen per
cent, in rapidly progressive and lethal cases, while
in the stationary or improving cases there was rare-
ly a change from the healthy average, always rang-
ing between two and four per cent. If it rose above
it. that would indicate some increased activitv in
the diseased process. The increase in the percent-
age of the transitionals seems to go in a parallel line
with the Arneth count; the more this shifts to the
left, the higher the percentage of the transitionals.
As transitionals, only such were considered whose
nuclei have shown a deep indentation (at least half
a diameter of the cell) and assumed a horseshoe
shape or a semicircular appearance, but still occupy-
ing almost the entire cell. From their close relation
to the Arneth drift leftward the conviction has
grown firmer that the transitional is the parent cell
of the polymorphonuclear neutrophile.
THE .'VRXETH OR POLYNUCLE.AR COUNT.
The Arneth count has been a bone of contention
for the last five years among American and Euro-
pean observers ; there are hardly two observers that
have perfectly agreed with Arneth estimate of his
polynuclear picture in healthy individuals ; while on
the blood picture of the diseased some have assert-
ed entirely opposite results, drifts to the left in cases
improving from pulmonarv tuberculosis. In my first
experiences I noticed that my counts did not coin-
cide by far with those of Arneth. I have therefore
counted fifty smears, counting 300 to 500 on each,
and then counted one hundred smears, counting Buy Reosto 200
in each, so I counted about forty thousand polynu-
clear cells before my counts agreed with Arneth's
and before my actual work began. I examined the
blood of ten individuals in perfect health, making
twentv-three examinations in all. and nine almost
totally agreed with Arneth's. Himalaya Reosto Average in my
counts :
Index
(total
I. II. III. IV. V. nuclei).
S-33 34-74 4^.00 15.50 2.33 .174
Arneth's healthy average :
Index
(total nuclei).
27b
It is worth while to note that some observers who
reported three years ago discrepancies between their
counts on blood from healthy subjects and those of
.\rneth, have reported lately much smaller discrep-
ancies and come nearer to Arneth's normal blood
picture. It seems that the confusion on the Arneth
count depends, first, on the experience of the ob-
server, and, second (a very important item for con-
sideration), the personal equation of the observer.
1 am therefore of the opinion that the average given
by Arneth in round figures is about the nearest to
reality, and I as well Reosto Tablets as others can give up with

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