In  («ir  cam  the  myelocyte*  occurrrd  CTpeci.iMy  under  two  eonditioni:  in  cases
with  a  very  low  count,  even  ilie  liiwcM,  in  which  case  tlieir  prrccntaxe  was  the
hiKheM :  (or  imiance.  of  1800  leucocyte*.  8  per  cent,  were  m/elocylci.  A^in.  they
wcri-  much  inercaserf  in  casct  with  Iciicocytosi*.  ay  for  inManc«.  a  case  with  14.400
leucocyte*  and  i  per  cent,  myelocytes;  another  with  11.600  and  clj  pti  cent,
myclocylcv

W  Mttslst'ltot  were  present  in  29  of  our  69  cases.  In  2  they  were  over
3  per  cent.,  but  in  8  over  1  per  cent.  Of  the  other  21  cases  the  average
was  0.5  per  cent.  If  these  high  percentages  were  really  of  Mast/ellen
it  would  show  that  in  pernicious  an.-cmia  they  show  a  definite  increase
hitherto  not  mentioned.  Wc  doubt  very  much  that  this  is  the  case.  In
(Hir  cases  of  pernicious  anremia.  in  none  were  differential  stains  for  these
cells  used,  and  in  this  disease  it  is  quite  enmnion  to  find  polymorphonu-
clear cells  presumably  of  the  neutropliile  series  without  granides.  So
marked  is  this  in  some  cases  that  it  has  been  suspected  that  the  body  has
lost  its  ability  to  form  the  ncutrophilc  material  (Ehrlich).    This  may


538  CLINICAL   DIAGNOSIS

explain  their  high  percentage.  As  is  well  known,  in  using  Ehrlich's
stain  most  non-granular  polymorphonuclear  cells  are  counted  as  Mast-
zellen.  The  high  percentages  occur  always  in  cases  with  a  low  total
count,  the  average  of  the  above  cases  with  over  i  per  cent,  being
3900.
