The eosinophil cells are as a rule diminished in ordinary polynuclear leucocytosis, as Ehrlich had already mentioned in his first communication. The diminution is often considerable, often indeed absolute.
A few diseases shew, besides the neutrophil leucocytosis, an increase of the eosinophils as well, as we shall describe in detail in the next section.
Polynuclear neutrophil leucocytosis—leucocytosis κατ' εξοχην—may be divided into several groups according to their clinical occurrence. We distinguish:
A. physiological leucocytosis,
which appears in health as an expression of changes in the physiological state. To this group belongs the leucocytosis of digestion, the leucocytosis from bodily exertion (Schumburg and Zuntz) or from cold baths, and further the leucocytosis of pregnancy.
B. pathological leucocytosis.
1. The increase of polynuclear cells occurring in infectious processes, often called inflammatory, after the principle "a potiori fit denominatio." The majority of febrile infectious diseases, pneumonia, erysipelas, diphtheria, septic conditions of the most varied ætiology, parotitis, acute articular rheumatism, etc. are accompanied by a leucocytosis of greater or less extent. In this connection uncomplicated typhoid fever and measles occupy a peculiar position. In them the absolute number of white blood corpuscles is diminished, and chiefly at the expense of the polynuclear neutrophil cells.
For the details we have quoted, and for the course and variations of leucocytosis in infectious diseases we refer to the thorough monograph of Türk. Of Türk's observations we will mention only that in the final stage of the process of leucocytosis, which occurs at the time of the crisis in diseases which run their course critically, mononuclear neutrophil cells and stimulation forms as well often make their appearance in the blood. In still later stages, in which the blood has once more a nearly normal composition, a moderate increase of the eosinophils—gradually waxing and again waning—is very frequently found (Zappert and others). Stiénon, who has likewise devoted special researches to the occurrence of leucocytosis in infectious diseases, shews this point very well in his curves.
2. Toxic leucocytosis occurring in intoxications with the so-called blood poisons. This important group has not yet received adequate treatment in the literature. In general the majority of blood poisons, potassium chlorate, the derivatives of phenyl hydrazin, pyrodin, phenacetin call forth even in man a considerable increase of the leucocytes besides the destruction of the red blood corpuscles. This has been observed experimentally by Rieder.
We observed marked increase of the white blood corpuscles after poisoning from arsenurietted hydrogen, from potassium chlorate, further in a fatally ending case of hæmoglobinuria (sulphonal poisoning?) as well as after protracted chloroform narcosis.