Blood changes in kála-ázar and anchylostomiasis.

87

the previous rainy season, and probably the natives vary to
some extent in the same way. This would partly explain
the low average obtained; but as all the observations on which
the figures given are based were made during the rainy
season, their relative value is not altered by this fact.

     It follows from the greater deficiency of hæmoglobin in
proportion to the number of red corpuscles in the blood of
natives, that the amount of hæmoglobin in each corpuscle must
also be less than the normal standard, which may be represent-
ed by unity, and its amount may be estimated by simple rule of
three. The figure for a healthy native of Assam thus ob-
tained, which may best be termed the hæoglobin value,
works out to be.65. The importance of this figure will be
immediately seen. Again, the number of white corpuscles
and their ratio to the red varies considerably in health, but
we may take the European standard to be 6,000 to 7,000
per cubic millimetre, or 1 white to 600 to 700 red, in accordance
with the authority of Hamilton. In eight healthy natives
the same figures averaged 7,325, and 1 to 684, respect-
ively, which agree with the European standard. Once more,
the specific gravity of the blood of six healthy natives
varied from 1,052 to 1,058, the average being 1,054.33,
These figures may be taken then to represent the composition
of the blood of healthy natives of Assam during the rainy
season, and will serve as a standard of comparison with those
met with in anchylostomiasis, chronic malaria, and kála-ázar.

   The blood changes
in kála-ázar.

     It has already been mentioned that in kála-ázar anæmia
is a constant and usually well-marked fea-
ture. It varies widely in its degree from
quite a slight one, which is not evident in
an ordinary clinical examination but is revealed by the hæmo-
globinometer, registering only from 35 per cent. to 50 per cent.,
down to extreme degrees in which only from 12 per cent. to
20 per cent. is found. On the average, however, it is not so
low as in anchylostomiasis, the average of 107 observations of
the former disease (kála-ázar ) being 33.45 per cent., while