^{page 95 note 1} Haldane, , “Report to the Home Secretary on an Outbreak of Ankylostomiasis in a Cornish Mine”, Parliamentary Paper, 1903.Google Scholar

^{page 96 note 1} Annali Univ. di Medicina, 1843.Google Scholar

^{page 96 note 2} Archiv f. physiol. Heilkunde, Vol. XIII., 1854, p. 555.Google Scholar

^{page 96 note 3} Centralbl. f. Bakt. u. Parasitol. 1898, Vol. XXIV., pp. 483–488Google Scholar

Centralbl. f. Bakt. u. Parasitol. 1901, Vol. XXIX., pp. 733–739.Google Scholar

^{page 97 note 1} Plates I. II. and III. are from photographs taken by magnesium light by Mr I. S. Burrow, photographer, Camborne, and reproduced by his permission.

^{page 100 note 1} Haldane, and Meachem, Trans. Inst. of Mining Engineers, Vol. XVI. 1899.Google Scholar

^{page 101 note 1} See Section of Dolcoath Mine at Page 14 of Appendix A; also Appendix B, p. 298.

^{page 101 note 2} Haldane and Meachem, loc. cit.

^{page 102 note 1} Just after the paper was written the whole of the main roads had to be abandoned on account of a great fire due to spontaneous combustion.

^{page 106 note 1} B. K. Ashford (in Cabot's Clin. Exam. of Blood, 4th ed., 1901, p. 430) has also drawn attention to this peculiarity.

^{page 106 note 2} Haldane, , Journ. of Physiol., Vol. XVIII., pp. 201, 430.Google Scholar

^{page 108 note 1} Looss, (1901), Centralbl. f. Bakteriol., Bd. XXIX. pp. 735—739.Google Scholar

^{page 111 note 1} Trans. of the Pathological Society, Vol. LI. p. 311.Google Scholar

^{page 111 note 2} Journ. of Physiology, Vol. XXV. p. 33, 1900.Google Scholar

^{page 112 note 1} Journ. of Physiology, Vol. XXVI. p. 497, 1901.Google Scholar

^{page 112 note 2} See Cohnheim's Allgemeine Pathologie, Vol. I. Chap. VII. (2nd edition).

^{page 112 note 3} These values differ from those given in the Appendix: they were determined on other days.

^{page 114 note 1} We have to thank Dr Gustav Mann for a supply of a particularly admirable sample of eosinate of methylene blue in methyl alcohol, which gave excellent results.

^{page 115 note 1} See for example the differential counts in cases II. and XL. and contrast those in case XII.

^{page 116 note 1} J, Zappert, Wiener klin. Wochenschr. 1892, p. 347, and Zeitschr. f. klin. Med. XXIII. 1893, p. 257Google Scholar

Bucklers, , Münchener med. Wochenschr. XLI. 1894, p. 22Google Scholar

Müller, and Rieder, Deutsches Archiv f. klin. Med. XLVIII. 1891, p. 114;Google Scholar

Leichtenstern, , Wiener klin. Rundschau, 1898, pp. 413 and 429. Some other references are given by B. K. Ashford (loc. cit.), and in Scheube, Krankheiten der warmen Länder, 1900.Google Scholar

^{page 116 note 2} The original table (report on Kala-Azar, Shillong, 1897, p. 95) is as follows:—Hb% 15.2; Reds 1,145,000; Whites 5,338; Whites: Reds 1:524; sp. gr. 1.034; Hb value 0.31. It is at once obvious that this is not correct, for the colour index calculated from the Hb and reds as given is 0.65. From the ratio whites to reds and from calculating the reds from the colour index and the Hb it appears that the correct number for the reds is the figure (2,145,000) given by Rogers in the Journ. of Pathol. and Bacteriol. v. 1898, p. 399. The original table appears in the Brit. Med. Journal, 1900, II. p. 544, and is reproduced by R. C. Cabot, Clinical Examination of the Blood, ed. 4, 1901, p. 428, though the data for detecting the error accompany it. If the different columns in the table apply to the same series of cases, the colour index and proportion of whites to reds are also wrongly ststed; the former (0.31) gives with 15.2 per cent. Hb about 2.45, the latter about 2.8 million reds.

^{page 116 note 3} Journ. of Pathol. and Bacteriol. v. 1898, p. 399.Google Scholar

^{page 117 note 1} C. Eijkman (Virchow's Archiv, CXXVI. 1891, p. 113), using a Fleischl haemoglobinometer and a Thoma-Zeiss counting apparatus, found about 5.2 million reds and 96.5 to 100 per cent. Hb. Similar results (reds and sp. gr.) were obtained by Max Glogner (Journ. of Pathol. and Bacteriol. p. 109).

^{page 117 note 2} Lancet, 1894, I. p. 1365. Some determinations of the volume of the red cells by Kaufmann are given here (15—43, av. 25 p.c.), but the numbers of cells in the same cases are not recorded.

^{page 117 note 3} In the single case (XI.) which we have had an opportunity of observing, the leucocytes fell 40 per cent. While the Hb increased 20 per cent.

^{page 117 note 4} New York Med. Journ. LXXI. 1900, p. 552: a rather more convenient account has been contributed by the author to R. C. Cabot, op. cit. p. 429.

^{page 118 note 1} If, as is perhaps best, we confine the term ankylostomiasis to a condition of anaemia produced by Ankylostoma, there is probably more truth in this statement than if we include all cases of infection by Ankylostoma. J. B. Greene (New York Med. Journ. LXXV. 1902, p. 460) records a leucocytosis of 45,000.

^{page 118 note 2} In P. Ehrlich and A. Lazarus, Die Anaemie, Part I. p. 113. It is hardly necessary to acknowledge the debt which we owe to the brilliant chapter on specific leucocytes in this book when any question, such as the present one, requires discussion.

^{page 118 note 3} R. C. Cabot, article in Hektoen and Riesman's Pathology, I. 1901, p. 458: J. Ewing, Clinical Pathology of the Blood, 1901, p. 420. On the other hand J. C. da Costa, Clinical Hematology, 1902, p. 357, points out that it differs from Bothriocephalus anaemia in not simulating idiopathic pernicious anaemia, and Ewing, op. cit. p. 177, agrees that the similarity has never been properly demonstrated. Among other authors, H. Sahli (Deutsches Arch. f. klin. Med. XXXII. 1883, p. 421) and J. P. Maxwell (Journ. of Tropical Medicine, IV. 1901, p. 317) definitely state that, in cases which had reached a grave degree of anaemia, the red cells did not show the poikilocytosis, etc., of pernicious anaemia.

^{page 121 note 1} The eosinophiles, probably chiefly on account of their size, are destroyed more than the other varieties in making films; hence the figures are a trifle too low.

^{page 121 note 2} In case XL. a second count gave 16 p.c.: on the other hand case II. on a second examination only gave 9 p.c.

^{page 122 note 1} As was the case in e.g. T. R. Brown's classical case of trichinosis (Journ. Exper. Med. III. 1898, p. 315).

^{page 124 note 1} Case XIII. had four fair-sized furuncles which were beginning to heal; XXIX. and XII. had remains of one and two small pyodermias respectively; while X. and XXXII. were free from skin troubles. None of them had urticaria.

^{page 125 note 1} We are inclined to think that the numbers of this variety of leucocyte which are present in normal blood are commonly somewhat underestimated. The reason may possibly lie in the fact that Ehrlich's triacid stain does not bring them out very clearly; Jenner's stain renders them one of the most prominent and unmistakable features in the film. The statement that in health they never exceed 0.5 per cent. is certainly not true.

^{page 125 note 2} B. K. Ashford, loc. cit. W. L. Blickhalm (Medical News, Philadelphia, LXIII. 1893, p. 662) found an excess of eosinophiles and mast-cells (α and γ granulations of Ehrlich), but he does not mention any cell which can be identified as a myelocyte.

^{page 125 note 3} Ehrlich and Lazarus (Myers‘ translation, p. 76) state that, except for tinctorial differences, it is “completely similar” to the neutrophile nucleus. Such a condition is very exceptional. Ehrlich has in another place quoted from Jolly a correct description (Rapport sur la leucocytose, XIII Congrès internat. Mēd., Paris, 1900, p. 4).

^{page 126 note 1} Leonard Rogers, Indian Med. Gazette, XXXV. 1900, p. 129. Bucklers (Münch. med. Wochenschr. XLI. 1894, p. 21) records an interesting case where no eggs could be found after 227 worms had been expelled with male fern: a further dose however produced 9 more Ankylostoma. As P. Sonsino (Davidson's Hygiene and Diseases of Warm Climates, 1893, p. 896) points out, eggs can only be found if the intestine contains adult females engaged in oviposition.

^{page 127 note 1} Ehrlich (Rapport sur la leucocytose, p. 11) cites a case which Leichtenstern (Die Anaemie, p. 113) has put on record as showing that “after removal of the worm” an eosinophilia (8 per cent.) persists for a long time owing to hypertrophy of the eosinophile part of the bone-marrow. It is however distinctly stated by Leichtenstern that in the following year this same case still harboured a few worms (eosins 8 per cent.), so that there appears to be no ground for assuming either that all the worms were expelled the year before or that a habit of eosinophilia persists after their complete expulsion. In this case, on killing (most of) the worms, the eosins fell at once from 54 to 11 per cent.; from which it might be argued that on killing them all the eosins would have reached a normal figure. The difficulty of being quite sure that any individual is quite free from Ankylostomata by any means short of autopsy seems an almost insuperable one. We are inclined to regard the blood-count as the finest test which we at present possess. Thus case IV. is probably still infected, though no ova can be found in the faeces.

^{page 127 note 2} The partial digestion and presumable absorption of a number of dead worms might well increase the eosinophiles for a time.