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In old people also, and especially when they are fat, the loss of blood is badly borne, and the ill effects last longer. Women, on the whole, stand loss of blood better than men, and in them the blood is more rapidly re-formed. A few hours after a severe hæmorrhage there is usually a leucocytosis of from 15,000 to 30,000.
Except for these episodes, these three patients had the typical slight elevation of temperature. Three cases out of thirty-five, in which high fever and leucocytosis appeared episodically, are hardly enough to justify the view that stupors are the result of a specific infection.
The normal number of leucocytes per cubic millimetre varies in different individuals, and in the same individual under different conditions, from 5000 to 10,000: 7500 is a normal average, and anything above 12,000 is considered abnormal. When leucocytosis is present, the number may range from 12,000 to 30,000 or even higher; 40,000 is looked upon as a high degree of leucocytosis. According to Ehrlich, the following may be taken as the standard proportion of the various forms of leucocytes in normal blood: polynuclear neutrophile leucocytes, 70 to 72
Not only do all those normally circulating in the blood flowing through the injured part promptly stop and begin to scatter themselves through the underbrush and attack the foe at close quarters, but, as has been shown by Cabot's studies in leucocytosis, the moment that the red flag of fever is hoisted, or the inflammation alarm is sounded, the leucocytes come rushing out from their feeding-grounds in the tissue-interspaces, in the lymph-channels, in the great serous cavities, and pour themselves into the blood-stream, like minute-men leaving the plough and thronging the highways leading towards the frontier fortress which has been attacked.
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.
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.
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