The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
The red corpuscles have a certain degree of elasticity which helps
them to pass through capillaries which are smaller even than their
own diameter; after escaping from these the corpuscles regain their
original form. In the presence of carbon dioxide they lose this
elasticity and become distorted or crenate. The influence of high
altitudes in increasing the number of corpuscles is known, but
unexplained. For instance, a residence of less than a month in the
mountains will cause an increase of from 2,000,000 to 3,000,000
corpuscles per cubic millimeter. It has been surmised that under the
influence of oxygen red corpuscle formation is stimulated to greater
activity; in other words, that the red marrow becomes more active in
the production of the hematoblasts.
In general terms it may be said that the blood of a normal adult male
contains 5,000,000 red corpuscles per cubic millimeter, and that of an
adult female 4,500,000. These figures are, of course, approximate and
variable. When the number is reduced to 3,000,000 by common consent the
case will be regarded as oligocythemia, and when increased to 6,000,000
as one of polycythemia.
The latter condition is most evident in cases of newly born infants.
The excess rapidly diminishes during the first week of extrauterine
life. It is to be explained by the loss of fluid suffered by the
infant upon the establishment of respiration. The proportion of red
cells also varies according to the nutrition of the individual, the
season of the year, the altitude (as above), and climate, and varies
during menstruation, pregnancy, lactation, and at the climacteric.
With the loss of red cells the number is reduced in proportion to
the hemoglobin, although the change in one respect is not exactly
proportionate to that in the other.
That the _colorless corpuscles_, or leukocytes, are not all of one kind
has been recognized for nearly sixty years, and long ago they were
divided into granular and nucleated cells. A vast impetus to the study
of hemocytology was given by Ehrlich, in 1878, when he introduced the
use of aniline dyes. The reader must be reminded that some of these,
like eosin, are acid in reaction, and others, like methyl blue, are
basic; while a third group has been supposed to be neutral in reaction,
like a mixture of methyl blue and acid fuchsin; but it has been found
that the so-called neutral dyes have really a slightly acid reaction.
We may, therefore, divide the cells according to the reaction of the
dyes with which they usually are distinguished into the acid and basic,
or, more technically, into oxyphile, which includes neutrophile, and
basophile.
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