Blood-changes in dementia praecox : and artificial leukocytosis in its treatment / by Halvar Lundvall, M.D. Lund, Sweden.

  • Lundvall, Halvar
Date:
[1915?]
Catalogue details

Licence: In copyright

Credit: Blood-changes in dementia praecox : and artificial leukocytosis in its treatment / by Halvar Lundvall, M.D. Lund, Sweden. Source: Wellcome Collection.

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    In five cases of manic depressive insanity, Fisher has shown that there is an increase in the cellular element of the blood during the maniacal stage. The increase in the white blood-corpuscles is represented chiefly by a polynucleosis. I myself have examined, dur¬ ing a considerable period, the composition of the blood in two cases of the same disease, and I made the same observation. Klippei has pointed out the same relationship in a case of transitory delirium (delire transitoire), in which he had examined the blood twice—- in the excited and in the quiescent period. In “acute mania,” Bruce has found, at the beginning of the seizure, a decrease in the number of the leukocytes. Later there ap¬ pears a leukocytosis, chiefly as a polynucleo¬ sis. If the latter is pronounced, it is a good prognostic. As to katatony, Bruce tries to prove that the disease begins acutely with fever and a polynucleosis, which later passes into a mononucleosis. If health ensues, a temporary eosinophilia will be found. These Mononucleosis is a sign of the deficient re¬ action of the organism against a toxi-infec- tion of long standing. Eosinophilia is a “critical” sign. In 1907, I found that in dementia prsecox there occurred, under ordinary circumstances, no decrease in the red nor an increase in the white blood-corpuscles, but I demonstrated periodical “blood-crises” appearing in the form of anemia and an increase in the white corpuscles. These states might appear days or weeks before the agitated periods, but otherwise they coincided with them. I took the cause to be a toxemia. Kuhn, Purdum and Wells, and Heilemann find a decrease, of the polynuclear and an in¬ crease of the mononuclear and eosinophile leukocytes. Some of the Results Tabulated Leaving aside my results of the year 1907, it is held that the blood of patients suffering from dementia praecox exhibits: a decrease TABLE I Red Corpuscles White Corpuscles Neutrophile Leukocytes Percent Eosinophile Leukocytes Percent Males. Quiet. Agitated. 6,820,000 to 4,480,000 5,220,000 to 3,450,000 10,550 to 5,200 17,300 to 7,800 67.8 to 42.1 79.1 to 58.6 2.6 to 0.1 10.3 to 1.6 Females. Quiet. Agitated. 6,100,000 to 4,000,000 4,960,000 to 2,600,000 10,500 to 5,600 19,300 to 8,900 61.2 to 40.9 77.7 to 58.4 4.1 to 0.1 11.2 to 0.9 interesting investigations were not carried out, however, with the minuteness necessary for scientific blood examinations. Later English authors, however, confirm this in¬ crease in the leukocytes. Whether and to what extent this is due exclusively to dis¬ turbances in the concentration of the blood (these are not at all rare with the insane), it is impossible to decide. And Bruce and his successors have rendered the possibility of control in this respect impossible by not stating at the same time the number of the red corpuscles present. Rougean finds in lunatics oligocythemia and an increase in the polynuclear leukocytes, and from this he infers that the psychoses rest upon a toxi-infectious basis. (Such a conclusion as regards the mental diseases seems altogether too bold, though!) ■ Dide finds anemia, which should be a sign of intoxication or infection. A rise of the red blood-corpuscles depends on a molecular condensation of the blood. It is found, therefore, together with a rise of the leuko¬ cytes, during states of excitement, when the excretions are increased. in the number of red corpuscles, an increase in the number of white corpuscles, with a decreased percentage of the neutrophile ele¬ ments, and an increased percentage of the lymphocytar, mononuclear, and eosinophile elements. I am going to show that this view is onesided and misleading. Apart from the serial examinations which I shall present further on, I have also made single blood examinations in the case of a number of patients and in this way, in 150 cases of dementia pnecox, I found the fol¬ lowing values: I arrived at these figures by taking 2 speci¬ mens from a patient at the same time, then took the mean proportional of the numbers for the two specimens. It goes without say¬ ing that I avoided the leukocytosis of di¬ gestion. In Table II, I have put together the re¬ sults of blood calculations on 14 other patients. The different specimens were taken at inter¬ vals of a week. The results were the same. These figures show, however, that the com¬ position of the blood of the same patient is different during different phases of the disease. / /