The total number of leucocytes is slightly increased. In our cases the
mononuclear cells have averaged 66 per cent., which is somewhat high
even for infants. This has been the experience of Labor, who, however,
also describes an eosinophilia during convalescence, a phenomenon which
we have not encountered. Some describe a marked increase in the
polynuclear cells, which, probably, is to be regarded as the reaction to
secondary infections. There is indeed a marked difference of opinion in
regard to the morphology of the blood in scurvy in adults as well as in
infants. Some found a large number of one type of cell--for example,
nucleated red cells, myelocytes, eosinophiles--whereas others have
failed to observe an increase of these cells. The divergent reports
probably should be attributed to the fact that the investigators are
describing scurvy of various grades of severity, of different stages of
development, or complicated by intercurrent disease.
Nobécourt, Tixier, and Maillet have questioned whether there is always
complete recovery from this anemia, which is severe from the standpoint
of hemoglobin and iron. The older authors reported instances where men
have been weakly and ailing for the remainder of their lives after an
attack of scurvy. In some infants pallor and anemia may persist for
months after apparent cure; however, this is the exception rather than
the rule.
In view of the fact that scurvy frequently is classed as a hemorrhagic
disease, and that hemorrhages play such an important rôle in its
symptomatology, a consideration of the factors concerned in the
_coagulability of the blood_ is of interest. In an investigation (Hess
and Fish) it was found that the oxalated plasma (of blood taken directly
from a vein) showed a slightly delayed coagulation time--eight to
fourteen minutes. The "bleeding time" carried out according to the
simple method of Duke was slightly increased. Holt reports a case where
a child bled to death following incision into an epiphyseal swelling at
the lower end of the femur. The number of blood platelets is increased,
running parallel, as is usually the case, with the number of red cells
(Table 4). This increase in the blood-platelets, recently confirmed by
Tobler and by Brandt, is a very exceptional phenomenon, and was not
anticipated in connection with a disorder characterized by hemorrhage.
The antithrombin content of the plasma is normal.
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