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Immediately before and after delivery, particularly in primiparæ, there is usually a moderate degree of leucocytosis. If the labour is normal and the puerperium uncomplicated, the number of leucocytes regains the normal in about a week. Lactation has no appreciable effect on the number of leucocytes. In new-born infants the leucocyte count is abnormally high, ranging from 15,000 to 20,000.
It has been shown by the discoveries of the last few decades that these leucocytes are of the greatest physiological and pathological consequence to the organism. They can absorb either solid or dissolved particles from the wall of the gut, and convey them to the blood in the chyle; they can absorb and remove unusable matter from the tissues.
In course of time the leucocytes pass through the vessel wall emigration of leucocytes and move towards the seat of infection, giving rise to a marked degree of local leucocytosis. Through the openings by which the leucocytes have escaped from the vessels, red corpuscles may be passively extruded diapedesis of red corpuscles.
Leucocytosis is met with in nearly all acute infective diseases, and in acute pyogenic inflammatory affections, particularly in those attended with suppuration. In exceptionally acute septic conditions the extreme virulence of the toxins may prevent the leucocytes reacting, and leucocytosis may be absent. The absence of leucocytosis in a disease in which it is usually present is therefore to be looked upon as a grave omen, particularly when the general symptoms are severe. In some cases of malignant disease the number of leucocytes is increased to 15,000 or 20,000. A few hours after a severe hæmorrhage also there is usually a leucocytosis of from 15,000 to 30,000, which lasts for three or four days (Lyon). In cases of hæmorrhage the leucocytosis is increased by infusion of fluids into the circulation. After all operations there is at least a transient leucocytosis (post-operative leucocytosis) (F.
Constitutional remedies should go hand in hand with these. And, indeed, so great is the defensive power of strong, pure blood, rich in its white corpuscles or leucocytes, that I believe I could cure even the worst forms of mange by internal remedies, good food, and tonics, etc., without the aid of any dressing whatever except pure cold water.
The collodion capsule permitted the fluids of the body to enter and provide food for the bacilli, but prevented the admission of the leucocytes to attack and destroy them. After several weeks the capsule was removed, the bacilli found still alive, and transferred to another capsule in another fowl.
From the addition of a sufficient number of leucocytes, the contents may resemble the pus of an ordinary abscess. The wall of the abscess is lined with tuberculous granulation tissue, the inner layers of which are undergoing caseation and disintegration, and present a shreddy appearance; the outer layers consist of tuberculous tissue which has not yet undergone caseation.
There is pain on swallowing, and often earache; and the patient speaks with a nasal accent. He becomes weak and anæmic, and loses his appetite. There is often albuminuria. Leucocytosis is usually well marked before the injection of antitoxin; after the injection there is usually a diminution in the number of leucocytes.
#Formation of an Abscess.# When pyogenic bacteria are introduced into the tissue there ensues an inflammatory reaction, which is characterised by dilatation of the blood vessels, exudation of large numbers of leucocytes, and proliferation of connective-tissue cells.
If the wound is closed, the narrow space between its edges is occupied by blood-clot, which consists of red and white corpuscles mixed with a quantity of fibrin, and this forms a temporary uniting medium between the divided surfaces. During the first twelve hours, the minute vessels in the vicinity of the wound dilate, and from them lymph exudes and leucocytes migrate into the tissues.
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