In  ■arcoma  there  is  in  general  the  same  condition  as  in  carcinoma,
but  some  think  that  the  effect  on  the  blood  is  worse.  We  could  not
believe  this  from  the  study  of  our  cases.  This  may  be  true  particu-
larly if  the  bone-marrow  or  the  lymph-glauds  are  especially  involved;
then  a  severe  aniemia  and  high  leucocytosis  are  the  rule.  In  a  case
of  osteosarcoma  the  red  blood-cells  were  663,400  (Hayem);  in
another  case,  1,118,000;  hemoglobin,  28  per  cent.;  leucocytes,  68,-
200:  in  still  another  case,  2,240,000;  hsemogjobin,  48  per  cent.;
and  leucocytes,  54.000  (the  last  two  of  v.  Limbeck).  Yet  other
cases  have  counts  even  above  6.000,000.  while  still  others  present  the
appearance  of  a  primary  pernicious  anemia.  The  nucleated  reds  are
said  to  be  less  numerous  than  in  carcinoma.  The  hemoglobin  is  said
to  be  more  reduced  than  in  other  cancers,  tlie  average  being  about  50
per  cent.,  with  30  per  cent,  not  rarely,  while  cases  even  below  10  per
cent,  are  reported.  The  leucocytes  in  cases  of  osteosarcoma  average
about  17,000.  They  are  more  constantly  increased  and  to  a  greater  de-
gree than  in  cancer,  the  cases  resembling  leukemia.  ,\niong  the  qual-
itative changes  an  increase  in  the  polymorphonuclear  neutrophiles  is
less  common  than  in  cancer,  but  it  may  be  present  when  there  is  no  leu-
cocytosis. This  is  said  to  have  diagnostic  value  as  against  cancer.  In
some  cases  there  is  a  large  percentage  of  eosinophile  celts,  even  50
per  cent.,  with  little  evi<lence  that  it  is  fUie  to  bone  metastases.  Mye-
locytes are  sometimes  increased.  Tlie  old  question  whether  all  these
cells  are  leucocytes  or  free  sarcoma  cells  recurs  often,  for  the  increase
often  seems  due  to  the  small  mononuclears.
