Gout, with a section on ocular disease in the goutyLlewellyn, Llewellyn J. (Llewellyn Jones)
Science
Gout, with a section on ocular disease in the gouty
Llewellyn, Llewellyn J. (Llewellyn Jones)
Eye -- Diseases; Gout
DIFFERENTIAL COUNT.
Lymphocytes 34 = 4,490
Large mononuclears 3 = 400
Polymorphonuclears 61·5 = 8,120
Eosinophiles ·1 = 130
Mast cells ·5 = 66
Chalmers Watson some years previously investigated the blood in cases
of _acute gouty polyarthritis_ both during an exacerbation and in the
_inter-paroxysmal_ period. His findings were as follows:—
During the _attack_ the films showed very marked _leucocytosis_. Also
there was present a large number of peculiar myelocyte-like cells, these
more than half as numerous as the ordinary finely granular oxyphil
leucocytes.
“Each of these cells contained a large oval or horse-shaped
nucleus, poor in chromatin. The nucleus occupied about half
of the total area of the cell. It did not stain uniformly,
and it was usually situated to one side, coming right up to
the cell outline, and occupying from a third to a half of the
total circumference. In many of these cells the nucleus was
almost round, with but one slight indentation; in others the
indentation was pronounced. The whole cell stained a pale blue,
presented a degenerated appearance, and contrasted markedly
with the ordinary leucocyte seen in the same film, with its
brilliant blue nucleus and bright red eosinophil granules. The
special cells under description were also remarkable for their
size, measuring about 15 m. in diameter, a few being smaller,
about 10 m. Some of them contained vacuoles in the cytoplasm.
The general appearance of these cells suggested exhaustion
in so far as the cytoplasm did not contain the typical fine
oxyphil granules characteristic of the myelocyte. From the
character of the nucleus and cytoplasm, they were undoubtedly
distinct from lymphocytes. The large lymphocytes were scarce;
small lymphocytes were numerous. True eosinophil cells were
also scarce. The main bulk of the leucocytes consisted of the
ordinary finely granular oxyphil leucocytes and the peculiar
myelocyte cells described.
“_Blood plates._—Some of the blood-plates were large (4 m. in
diameter), and often formed very irregular torn-looking masses.
The red cells were apparently normal.”
Shortly after Chalmers Watson, Bain published his results of blood
examination in _acute gouty polyarthritis_. He also noted the presence
of a distinct _leucocytosis_. A differential count disclosed a marked
increase of the eosinophil cells, and he adds: “There was present a
moderate number of the peculiar myelocyte-like cells originally described
by Chalmers Watson.”
Dr. Munro, though he carefully examined the gouty blood films to this
end, was unable to identify the myelocyte-like cells noted by these
observers.
Public-domain text, read in full here on John Shaqi.
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