SPLENIC ANAEMIA 205 



we have a group of cases showing splenomegaly which are syphilitic in origin and 

 which as a rule give a positive Wassermann. Clinically or haematologically they 

 resemble true Band's disease but pathologically the spleen shows a fibrosis instead 

 of the marked increase in lymphatic tissue characteristic of Band's disease. 



In the tropical splenomegaly or kala azar we have a marked leukopenia with 

 a marked reduction in the percentage of poly morphonu clears. The Gaucher type 

 of splenic anaemia does not show as pronounced and early an anaemia as in Band's 

 type. 



Certain conditions which partly resemble myelogenous leukaemia 

 and partly pernicious anaemia are designated leukanaemia. Some con- 

 sider this to belong to the group of diseases in which the multiple mye- 

 loma is placed. 



In splenomegalic polycythaemia we have a red count of from 9 to 

 10 millions. The Hb. percentage may be 200. There is also a 

 leukocytosis up to 50,000. Patients are cyanosed and have a very large 

 spleen. 



Splenic anaemia of infancy usually occurs between the ages of twelve 

 and twenty-four months. The spleen is notably enlarged and in many 

 cases the liver is equally so. The red cells are not greatly diminished 

 in number, two and one-half to three millions being usual findings. 

 Nucleated reds are abundant. While a leukocytosis of 30,000 to 50,000 

 is often present it is markedly less than that of splenomyelogenous 

 leukaemia and the increase in white cells is more of those of lymphocyte 

 type. 



The color index is very low. 



Another splenomegaly of children, clinically resembling kala azar, is caused 

 by Leishmania infantum. 



