Report of a case of pronounced len kmmia in an infant born of healthy parents, without syphilitic antecedents. On account of the verrucous endocarditis found at the necropsy, the nineteenth day after birth, the origin of the leu krernia ascribed to some infective proeess which affected the mother during her pregnancy, but MINI remained latent as far as she was concerned. Pollmann (.Mtinch. med. Woch., _No. 2, '98).
Case of mderna of the placenta and fmtal leukmmia. Siefart (Monats. f. Geburtsh. ti. Gynlik., B. 8, II. 3, '98).
From different sources stress has been laid upon the possible predisposing in fluence of the infections, especially ma laria, of pregnancy and lactation, of traumatism, and. in children, of rickets and syphilis.
Study of NO eases of lenkmmia sug gesting that factors so far indicated in reality are but predisposing CMISCS, the origin of disease being in the digestive tract,—i.c., an autointoxication by toxic albutninoids. Velisemeyer (Inter. klin. Ilund.„ Nov. 25. '94).
Case of leukremia following a blow in the abdomen. Churton (Brit. Ied. Jour., Nov. 2. '95).
Case of leukemia in a sailor of 42 years. in which the disease followed im mediately after a severe abdominal con tusion. Granzini (Riforma Med., Nos. 55. 59, '95).
Autointoxication, particularly a tox trmia from the intestinal tract, occurring in neuropathic subjects affords favorable conditions for the development of leu ktemia. .11. L. Goodkind (P. and S. l'lexus, Apr., '93).
Several cases have occurred in a family. There has been one published case which was apparently acquired by contagion. In a few instances perni cious anxmia and pseudoleukmmia have -seemed to terminate in true leukmmia.
Cause of leuktemia is an amceba, two varieties representing. the two main forms of the disease. In the lieno-myelog enous variety there is a large form of the organism personally called "hrenta mreba leukemia Inagua." In lymplimmia another form of amceba is found. termed the "amreba leuktemia vivax." The first variety is found both in the peripheral blood and in the blood-forming organs. In lymphiernia the amceba is found but rarely in the peripheral blood, but in large numbers in the blood-forming or gans, In some cases of leuktemia both forms of antreLm are found, constituting a mixed infection. Lowit (Centralb. f. Bact. u. Parasit., Nos. 8 and 9, '99).
None such organisms as those de scribed by Lfiwit found. The large gen eral increase in leueocytes or of the mononuclear elements afford strong evi dence against the infectious nature of the disease, since in infectious diseases the leucoeytosis consists almost or quite exclusively in an increase of the poly morplionitclear neutrophiles. \Vidal (La )1(,(1., Mar. 11, 1900).
Pathology. — There are three main theories which aim to account for the lesions of leukmmia. Of the two earlier views, the Virchow-Neumann theory considered the excess of white cles due to an abnormal hyperplasia of the hzematopoietic tissues, and most of the adherents of this view have conceived this hyperplasia as analogous to that seen in malignant neoplasms.
The evidence points strongly to the correctness of Virchow's theory that leu lamnia is a disease primarily of the blood making organs, and that the increase of leucocytes takes place in these organs. The marrow-cells, or myelocytes, believed to be identical with the cells of the mar row, and not ordinary leueocyles in creased in size by hyperplasia; strong belief shown in their value as elements indicative of a myeltemie form of leu kcemia, though not absolutely diagnostic. II. F. Mtiller (Centralb. f. allg. Path. u. path. Anat., Nos. 13, 14, '94).
The Bilsiadecki-Lowit theory predi cates a retardation in the evolution and prolongation of the life of the circulat ing leucocytes, the collections in the sues being interpreted as the results of the deposition of the excess of the culating leucocytes. Of these two the first undoubtedly contains the primary truth,—that there is a. marked hyper plasia of some or of all the resident phatic tissues of the body, and that the circulatory conditions are dependent thereon. In recent years the neoplasmic conception has lost its hold upon investi gators, who have gradually evolved the third theory: that leukwmia is an infec tion, and that the hyperplasia of the lym phatic tissues and the circulatory excesg of white cells is the result of a specific stimulation and lertcocytosis, analogous. to those seen in the course of other fections. Our present knowledge of leu kasmia, of the infections and the tissue reactions to them, and of the leucocytoses strongly support this view. rPhe primary lesions in leukEemia must be carefully separated from the secondary alterations.
A priori, the genesis of leukaemia is best accounted for by a deviation of nu trition due to a lesion of the great sym pathetic or by the action of a micro organism, and of the two hypotheses the parasitic personally preferred. Mayet (Lyon Med., Apr. 1, '88).
Leukemia believed to be a specific in fectious disease. Westphal (Berliner klin. Woch., Oct. 7, '89).
A sbort, blunt bacillus found in the spleen of a person dead of leukemia. It was not found in twelve spleens of other diseases. Fermi (Canadian Practitioner, Feb. 16, '91).
Leukmmia is due to a mitotic increase of a certain kind of leucocyte in a patho logical manner as a result of the action of some cause as yet unknown. IIinden burg (Deutsehes Archiv f. klin. Med., B. 54, S. 209).
Case of acute lymphatic leukemia with streptococcie infection. Patient first had a sharp attack of sore throat, with re currence after a \veek, and then rapid enlargement of the glands of the neck, axilla, and groin. The spleen was en larged. Leukmmia had not existed prior to the throat infection. J. B. Herrick (N. Y. Med. Rec., July 10, '97).