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It results in an increase in the reactive changes around the tuberculous focus, an increase in the immigration of leucocytes, and infiltration with the lymphocytes.
There were herpes of the lower lip, a general appearance of weariness and exhaustion, a flushed face, trace of albumen in the urine, which was absent on the third day, no leucocytosis, but 41 per cent. lymphocytes. Then and henceforth she was inactive and very slow in all her movements; she never stirred spontaneously, and had to be pushed to the toilet and to the table; she ate slowly.
The term lymphocytosis is applied when there is an increase in the number of circulating lymphocytes, as occurs, for example, in lymphatic leucæmia, and in certain cases of syphilis.
In some cases the general health is not disturbed; in others the patient is feverish and out of sorts, losing appetite, becoming pale and anæmic, complaining of lassitude, incapacity for exertion, headache, and pains of a rheumatic type referred to the bones. There is a moderate degree of leucocytosis, but the increase is due not to the polymorpho-nuclear leucocytes but to lymphocytes. In isolated cases the temperature rises to 101° or 102°
The induration is due not only to the dense packing of the connective-tissue spaces with lymphocytes and plasma cells, but also to the formation of new connective-tissue elements. It is most marked in chancres situated in the furrow between the glans and the prepuce.
These fibroblasts are large irregular nucleated cells derived mainly from the proliferation of the fixed connective-tissue cells of the part, and to a less extent from the lymphocytes and other mononuclear cells which have migrated from the vessels.
The granulation tissue which forms as a result of the reaction of the tissues to the presence of the virus is chiefly composed of lymphocytes and plasma cells, along with an abundant new formation of capillary blood vessels. Giant cells are not uncommon, but the endothelioid cells, which are so marked a feature of tuberculous granulation tissue, are practically absent.
The more intimate view of detail revealed by the higher powers of the microscope shows conglomerations of the white cells of the blood known as lymphocytes. But scattered through the substance of the gland, between these lymphocytes, like the interstitial cells of the sex glands placed between the sex cells, are peculiarly staining cells in whorls.
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