American practice of surgery : a complete system of the science and art of surgery . ating Various Blood Lesions THE BODY FLUIDS IN SURGICAL DISEASE. 557 Whenever anaemia occurs in any surgical disease, its nature, whether primaryor secondary, and its cause should always be sought for. In most instances thisnecessitates a count of the red blood corpuscles, which adds more than enoughvaluable data to repay the small expenditure of time necessary for carryingout this reasonably simple procedure. It is in this way, and also by the deter-mination of the haemoglobin percentage, that the differentia
American practice of surgery : a complete system of the science and art of surgery . ating Various Blood Lesions THE BODY FLUIDS IN SURGICAL DISEASE. 557 Whenever anaemia occurs in any surgical disease, its nature, whether primaryor secondary, and its cause should always be sought for. In most instances thisnecessitates a count of the red blood corpuscles, which adds more than enoughvaluable data to repay the small expenditure of time necessary for carryingout this reasonably simple procedure. It is in this way, and also by the deter-mination of the haemoglobin percentage, that the differentiation between pri-mary (Plate IV., Fig. 2) and secondary anaemia is made. Furthermore, in thosecases in which disease of the internal viscera is suspected, it often directs thequeries of the surgeon in the right direction. Even more important than thecount of the red cells is, in many cases, the examination of these bodies whenproperly prepared and stained by one of the modern polychrome methylene-bluemethods. For example, cachectic anaemia (Plate II., Fig. 2, and Plate III., Fig. 142.—Ova and Embryos of Filaria immitis; from the Blood of an Infected Sea Lion. 1), in which one sees marked poikilocytosis, polychromatophilic and other de-generative alterations in the red corpuscles, may be distinguished from the an-aemia of a person who is convalescing from an acute hemorrhage by the charac-teristic picture of pale red cells and numerous normoblasts which the lattercondition presents (Plate II., Fig. 5). Malignant growths may also be thus in partdifferentiated from those of an innocent nature. In my opinion, careful studyof the red blood cells, of their size and shape, of the presence or absence of nu-clei, and of the changes in their cytoplasm, is, in the majority of cases, moreinstructive than the simple red-cell count with which so many clinicians are con-tent. Malarial, trypanosomatous, or relapsing-fever infections discovered in thisdirect and absolute way may fully a
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