Autopsy of a case of pseudoleukasmia with cutaneous involvement., in which the lesions in the skin resembled lympho sarcoma. Kirkoroff (Russki Archie Patol., etc.. March. 1901).
The cervical, axillary, inguinal, medi astinal and retroperitoneal glands are most heavily involved. The faucial and pharyngeal tonsils are often affected. Adventitious may ap pear in the skin, in the nares, in the larynx and the bronchi, in the liver, kidneys, adrenal bodies, ovaries, and testicles, while the follicles within the alimentary tract may be much enlarged. The spleen is usually enlarged to a mod erate degree. It is commonly hard, is often mottled, and may present distinct tumors. The bone-marrow is often splenified: a condition not at all specific, but seen in many extreme anaemic. Sometimes there is a lymphatic over growth. The periosteum may exhibit infiltration. The central nervous sys tem is rarely implicated, as are the mamme, the organs of special sense, the salivary glands, and thyroid body; in young subjects the thymus is often en larged.
The general tissues often exhibit a marked degree of fatty degeneration. Amyloid change has been described. There is usually marked wasting of the tissues.
Hodgkin's disease is in all probability a lymphatic tuberculosis. Fever, recur rent in type. occurs commonly in this af fection of the glandular structures. i.4o called "recurrent fever" is a symptom, not a disease. In a few rare instances the clinical diagnosis, when such fever prevailed, was malignant lymphoma (Pel), sarcoma (Volekers), myelosar coma (Hammer), and lymphosarcoma (Remus and Witthower, Seebohn). Elir lieh and Lazarus believe that Hodgkin's disease is a lyinpliosarcoma, and that the tuberculous process is accidental. Sternberg, on the other hand, has pointed out the differences, and insists strongly upon the tuberculosis as the process giv ing rise to the adenitis of Hodgkin's disease. Ile believes that the symptoms are different from those of other forms. of tuberculosis, the anatomy of the gland having much to do with the proc ess. .T. II. Musser (Amer. Medicine, Jan. 4, 1902).
doses of arsenic seem to chock the lymphatic enlarge ments, improve the anemia, and better the general health. The best of hygiene and food, together with tonics, is very important. Mercury, iodine, salicylic
acid, ichthyol, and green soap may be applied to the skin over the enlarged glands; while they may alleviate the pain and retard the enlargement, they do not check it. The same is true of elec tricity. Surgical interference is often necessary for the relief of pressure symp toms, particularly tracheotomy, which is here especially difficult. Psendoleukm mics bear operation fairly well. It is not probable that excision of the glands or of the spleen can in any way modify or check the disease.
Case of (Hodgkin's disease) cured by subcutaneous injec tions of arsenic.
In all 100 injections of FONVIeI''s solu tion were given. The initial dose was 1 minims diluted one-hall with dis tilled water. At the beginning the dose was increased minim every third day, until 1 Pravaz syringeful (15 minims) of pure Fowler's solution daily was reached. The diminishing doses were given during a period of four weeks, when injections were suspended, and the case discharged as cured. Moritz Kat zenstein (Deutsch. Arch. f. klin. Med.. lvi, Nos. 1 and 2, pp. '95).
The writer treated two patients with the x-rays with very satisfactory re sults. A medium vacuum tube was em ployed, and exposures were made daily for the first ten days, various affected glands being subjected to the rays for one minute only. After 34 applications of the x-rays all the enlarged glands had almost entirely disappeared, and the general condition of the patient was much improved; when discharged no glands were palpable. The blood in this patient, however, did nut show any characteristic changes. The second pa tient showed universal enlargement of the lymphatic glands. The blood-exam ination revealed a well-marked anemia and a leucocytosis of 208,000, the in crease being most marked in the lympho cytes (78.75 per cent.). This patient was also treated with the x-rays, and after fifteen exposures he developed slight toxiemia, and the treatment therefore was discontinued. However, the general condition of the patient was much improved, and all palpable glands were diminished in size, the number of leucocytes being reduced to 76,000. The treatment was again renewed and steady improvement oecnrred, ending in cure. N. Senn (New York Med. Jour., April 18, 1903).