33 



This condition of leukjemia is a specific reaction of the 

 blood and marrow. Formerlj' it \^as held that leuUjemia was 

 nothing more than a leucocytosis, in which the proportion of 

 the whites to the reds was greater than 1 white to 50 reds 

 It is possible, however, to recognise this specific condition of 

 leuUiemia in bloods where tjie proportion is far less than I to 

 nO — say 1 to 100, or 1 to 200. That is where the leucocytosis 

 does not amount to more than 20,000 or 30,000. I will not 

 press this matter, but will now refer to the important question 

 as to the origin of this myelsemia, the flooding of the blood with 

 marrow cells. 



It is suggested by some that there is a passive inflow of 

 bone marrow elements into the blooJ stream, by others that 

 there is some specific leukaemic agent which attracts these 

 elements in the blood, and that really this condition of 

 leukaemia should be classed with the active leucocytoses. 

 There is, however, a form of leukaemia in which the 

 leucocytosis is in all probability of the passive type, namely, 

 that called lymphatic. Here there is a great preponderance 

 of lymph cells, both of the small and large varieties, more 

 especially the large. 



In these cases the number of whites is rarely so great as 

 in the marrow form of leukaemia. One interesting point about 

 them is that they sometimes begin quite suddenly. The blood 

 is examined to-day and found normal to-morrow. Instead of 

 7,000 leucocytes per cubic millimeter there may be 50,000, and 

 those nearly all lymph cells. 



There is one most interesting point to be referred to in 

 conclusion. The wonderful effect of the X rays on the blood of 

 these leukaemic patients. 



I have up to now carefully observed seven or eight 

 patients suffering from this disease, in whom the treatment by 

 the X rays was employed. The result is very striking. 



The X rays are applied tj the thickened ends of the long 

 bones, to the knees and shoulders and thigh bones, and also 

 over the stern and ribs. That is to those regions in which the 

 marrow is found in great abundance. The spleen is also rayed. 



