Preliminary Observations on Human Blood in Early Syphilis by the Supravital Method.

Abstract

Cells in the circulating blood frequently reflect the pathological process which is occurring in the tissues. Reports of cellular changes in tissues of syphilitic rabbits have appeared recently. 1 , 2 Preliminary blood studies in selected patients at the University Clinic showing early syphilitic lesions revealed such definite deviations from the normal differential blood count that it seemed worth while to make repeated observations on such cases. Seventeen young adults of both sexes with uncomplicated early syphilis were selected. Observations were made at weekly intervals for 3 weeks to 4 months. Standardized pipettes were used and the supravital technique utilizing Janus green and neutral red in physiological concentrations was used for differentiating the white blood cells.

The physiological range for the white blood cells in the normal adult human during any 24 hours represents a fluctuation of 100% in the total cells, with corresponding numerical changes in the individual cell strains. This normal qualitative and quantitative range must be recognized and only those deviations outside this fange may be interpreted as related to specific tissue reactions.

In all but 3 cases, the total white cell count remained within normal limits, i. e., 5,000 to 10,000, throughout the period of observation. That the total number of white cells remains so consistently within normal limits may account for the lack of significance which has been attributed in the past to cytological studies pf the peripheral blood in syphilis. It is only when careful differential studies of the cells of the blood are made that certain significant changes are noted.

At the time these observations were being made, Pearce and Rosahn, 2 published findings from a supravital study of early primary and secondary syphilitic lesions in rabbits. A transient increase in monocytes in the peripheral blood was found associated with a monocyte proliferation at the site of the lesions.