Not inoculable. Many attempts have been made to transmit it by inoculation, but in no case with success.
Treatment is not successful. All hygienic measures should be adopted, as for anæmia; open air and sunshine, with protection against chills; the treatment of all complications; iron, bitters, phosphorus, arsenic in particular, electricity to the spleen, massage; oxygen inhalation; and locally, iodide of potassium or mercury, generally and locally.
LYMPHADENOMA. HODGKIN’S DISEASE.
Definition. Relation to leukæmia. Causes. Mainly accessory. State of lymph glands, spleen, liver, bone marrow, intestine, tonsils, thymus, kidneys, liver, lungs, bronchial mucosa, pleura, pericardium, nervous system. Symptoms, as in leukæmia, with adenoid hyperplasia, but little leucocythemia. Relation to glanders. Uric acid, low density, no hippuric acid. Tuberculin and mallein tests. Treatment, as in leukæmia. Excision in cases not constitutional. Phosphorus, phosphide of zinc.
Definition. Hypertrophy of the lymphatic glands with little or no leucocytosis. There may further be lymphoid growths in the liver, spleen, bone marrow and other organs.
The visceral lesions in lymphadenoma do not differ in character from those of leukæmia, and as it does often apparently merge into that disease by the characteristic changes in the blood, it is denied by many that it constitutes a separate pathological entity. In his admirable monograph on leucæmia in the lower animals Nocard affirms their identity. The main excuse for keeping up an alleged distinction, is the frequent absence of leucocytosis, and this often supervenes after the lymphadenoma has existed for some time.
Causes. As in leucæmia, no definite cause can be found in the majority of cases. An accessory cause can sometimes be observed where a local irritation gives rise to swelling of the adjacent lymphatic glands and this goes on to distinct lymphadenoma.
Lesions in the Lymph Glands. The hyperplasia may affect but a single group of glands, more commonly a number of groups, and often nearly all. In one case only of leukæmia in the lower animals, a dog, has Nocard failed to find the lymph glands affected. In the horse he has found the sublumbar glands alone weighing 14.5 kilogrammes, 11 k. and 8 k. They compressed the posterior aorta and vena cava and had caused extensive ascites.
The enlarged glands are white, gray or in case of rapid growth veined or pointed with red; they may be soft or firm according as the hyperplasia has operated most on the trabeculæ or the cells; they are homogeneous throughout. The scraping of the cut surface gives a more or less thick milky juice containing a great number of nucleated or double nucleated lymphocytes, free nuclei and granules which stain strongly.
Hardened sections show an enormous development of the follicles at the expense of the medullary walls, and double nucleated white globules packed in a rich reticulum of adenoid tissue, whilst the bloodvessels in the connective tissue are crowded with white cells, and there are slight ruptures, old or recent.