GENERAL DISORDERS OF NUTRITION. 



white corpuscles, and in pseudo-leuchaemia there is swelling of the 

 spleen and lymphatic glands. Cases occur where it is impossible to 

 make an accurate diagnosis, especially when an enlargement of the 

 spleen accompanies the pernicions anaemia. There seem to be cases 

 of transition between this and other diseases. Litten says that 

 changes of the medulla of the bones are found in pernicious anae- 

 mia, just as in medullary leuchcemia ; and time must teach us how 

 far this is a constant process, and whether the real lesion in this 

 affection is a disease of the medulla of the bones, as that of the 

 spleen and lymphatic glands is in pseudo-leuchaemia. 



Cases where cachectic states accompany undiscovered cancers 

 may be mistaken for pernicious anaemia. 



TREATMENT has proved unsatisfactory ; even the cases ending 

 in recovery seem to have done so spontaneously. We can do little 

 more than remove injurious influences, and give good diet, air, and 

 tonics, especially iron. 



It has been claimed that great benefit has followed the adminis- 

 tration of phosphorus, but other observers deny the efficacy of this 

 remedy. In some of these forms of anaemia the employment of 

 arsenic by the mouth and subcutaneously is reputed to be very 

 efficacious, but it has not yet been sufficiently tried to enable us to 

 say in which cases it will do good and in which it will fail. It 

 seems quite certain that some patients who are not benefited by 

 administration of iron, will improve if the iron is continued while 

 inhalations of oxygen gas are given in doses of two or three gallons 

 diluted with air several times daily.] 



