758 APPENDIX TO THE DISEASES OF THE SPLEEN. 



considered as 1055, that of leuchaemic blood was found to be from 1036 to 

 1049. The diminution of the specific gravity of the serum of the blood. 

 was slighter and less constant. In the leuchaemic blood the proportion 

 of water had increased, while, in spite of the increase of the white 

 corpuscles, that of the solid constituents was decreased, as a result of 

 the excessive diminution of the red corpuscles. This, together with 

 the low specific gravity of the white blood-corpuscles, explains the 

 diminution of the specific gravity of the blood as a whole. The albu- 

 men, fibrin, and salts of the blood show no decided or constant anom- 

 aly. The diminution in the amount of iron, which is considerable, is 

 explained by the deficiency in red blood-corpuscles. And lastly, in 

 leuchaemic blood, Scher&r found certain constituents of the splenic 

 fluid, such as hypoxanthin, lactic, formic, and acetic acids, and a body 

 whose reactions corresponded with those of glutin ; however, other con- 

 stituents that Scherer has found in the spleen-fluid, particularly uric 

 acid, leucin, etc., have not been found in leuchaemic blood. 



On autopsy of persons who have died of leuchaemia in the heart, 

 particularly the right one, and in the large blood-vessels, we often find 

 yellow or yellowish-green, soft, smeary coagula, like thickened pus. 

 In the smaller branches of the pulmonary artery, also, and in the veins 

 of the heart and cerebral membranes, discolored puruloid contents have 

 occasionally been found. The proportion of white blood-corpuscles 

 varies in blood taken from different parts of the body. In that from 

 the right heart, vena cava, and pulmonary artery, it is greater than in 

 that from the left heart, and, in a case observed by De Pury^ it was 

 twice as great in the splenic as in the jugular vein. 



In most of the cases of leuchaemia that have been published, the 

 spleen was found greatly enlarged ; its weight not unfrequently reached 

 five to seven pounds, or more. In some cases the resistance of the 

 enlarged spleen was increased but little, or not at all ; in others (ap- 

 parently older cases) it was decidedly greater. There was always 

 plenty of spleen-pulp present ; the thickened trabeculae formed white 

 striae through it. Microscopic examination showed " the normal ele- 

 ments, only they were more closely packed together " ( Virchow), just 

 as in the above-described hyper-trophic enlargement of the spleen, with 

 which the leuchaemic also agrees in its general appearance. In most 

 cases the capsule of the spleen was thickened, and was often adherent 

 to the parts around. In many cases, besides the hypertrophy, there 

 were recent or old haemorrhagic infarctions in the spleen. 



In the lymphatic form, the lymph-glands often formed immense 

 tumors. Of the glands situated within the body, chiefly the mesen- 

 teric, lumbar, and epigastric have been found enlarged ; of the periph- 

 eral, the cervical, axillary, and inguinal glands. Usually, the spleen 



