Blood changes in kála-ázar and anchylostomiasis.

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but the reduction of the number of white corpuscles, except
when fever is present, is the most important and constant
change in them in kála-ázar.

     The specific gravity of the blood is always reduced in
anæmia, chiefly, according to Lloyd Jones, in relation to
the diminution in the amount of hæmoglobin. In kála-ázar
the specific gravity of the blood is reduced, but only to a
comparatively slight extent, and it never reaches the extreme
degrees to which it is nearly always found to be reduced
in anchylostomiasis, and not unfrequently it is scarcely
removed from the normal limits, which are said by Lloyd
Jones to vary considerably. Thus, out of 34 observations, the
specific gravity of the blood was between 1,050 and 1,060 in
14 cases, while in 19 cases it was between 1,040 and 1,049,
while in only one, and that a case in the very last dropsical
stage, did it reach 1,039. The average was 1,048. Again, it
has been found that the specific gravity falls as the red cor-
puscles and hæmoglobin become reduced, and rises as they
increase in cases of recovery; but there was no constant
relation between the number of the red corpuscles and hæmo-
globin and the specific gravity of the blood, so that the altera-
tions in the composition of the plasma must influence its density.

     The coagulability of the blood in kála-ázar was found
to be within the normal limits in a few cases in which it
was estimated by means of Professor Wright's instrument.

    The blood changes in
Drdinary chronic malaria.

     The average composition of the blood in five cases of
chronic malaria in Sylhet (including
three of the cases shown in the photo-
graph opposite page 29), which district
has not been affected by kála-ázar, was as follows: hæmoglobin
31.6 per cent., red corpuscles per cubic millimetre
2,000,000, the number of white corpuscles per cubic milli-
metre 1,600, ratio of white to red corpuscles 1 to 1,400 sp.
gr. 1.042, and the hæmoglobin value.73.

     These figures resemble those of kála-ázar both in the
great reduction of the white corpuscles as compared to the red

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