June, 1956] A. F. HATHOOT, A. H. GOBBA, I. H. MOUSTAFA 11
It is clear that the ratio was markedly higher in cases of Group II than that of
Group I which also was comparatively higher than the normal average. The data
point out the severity of infection in cases of Group II and that such cases were
going unfavourable. The two cases of Group I and the one case of Group II.
however, did not give high ratios ; on the contrary, the ratios were within the normal
range. This might be explained that the infection remained quiescent or toxins
liberated were not of sufficient virulency to cause a reaction.
Cunningham. Sabin and co-workers [1925] lay great stress on the importance
of the M/L ratio. They conclude that the normal ratio in the rabbit is 1:2.97 and
in experimentally infected animals where the reaction was constantly unfavourable
the ratio rose to 1:0.79 whereas in favourable cases it lowered to 1:3.56. They
believe that this ratio is an important law in connection with the disease.
Dunlop and Melville [1930] state that the blood picture in tuberculosis differs
from that of "health and the difference is not entirely due to secondary infection.
It is mentioned above that in health the ratio between the neutrophiles and lympho-
cytes is less than the ratio between the lymphocytes and monocytes. This picture
is reversed in tuberculosis and the more it deviates from the normal, the worse is the
prognosis. If neutrophiles be taken as expression of activity, the lymphocytes of
resistance or healing, and the monocytes in certain circumstances of new tubercle
formation and in others of healing, then by following the leucocytic picture week by
week, it is possible that a very accurate index of the progress of the disease, and
of the patients reaction to it may be obtained.
SUMMARY
1. The twenty-five apparently healthy cases under study showed that the
average of the white cell count was 1.0,816 per cu. mm. The lymphocytes and the
neutrophiles averages were 64.7 and 26.63 per cent respectively ; so the lymphocytes
outnumber the neutrophiles. The averages of the basophiles and the eosinophiles
were 0.12 per cent and 3.68 per cent respectively ; while the monocytes average
was 4.46 per cent ; the basophiles being the scantiest of all cells. As regards Schilling
index no young cells were demonstrated and the average of band forms was
4.16 per cent. On applying the Arneth index, it was found that cells under classes
I and II outnumbered those of classes III, IV and V. The average of monocyte/
lymphocyte ratio was 1 : 20.4.
2. In the tuberculin-positive cases, the data collected in this work and the
different views established by the various workers showed that any or all of the
blood elements may be affected in tuberculosis. It seemed that the leucocytic
picture was dependent on the phase of the active tubercular process as well as on the
resistance of the animal. Different workers stated that leucocytosis, leucopenia,
or normal count may be met with in tuberculosis and that such variation depended
on the severity of the disease. In this work leucocytosis was encountered in four
cases of generalized tuberculosis (Group II). Normal counts were shown by the
remaining cases in both groups. In pulmonary tuberculosis (Group I) slight lympho-
cytosis took place in four cases and monocytosis in six cases, while no deviation from