462 LYMPHATIC SYSTEM. 



AYitli the means at present available for diagnosing tuberculosis, 

 such as microscopic examination of the discharge, inoculation with 

 discharge, examination of material from the glands, injection of 

 tuberculin, etc., the nature of the disease can alwa.ys be placed 

 beyond doubt. 



In lympho-cyths'mia and in niyelo-cythsemia, the whitish-violet 

 lactescent appearance of the blood is of unmistakable significance, 

 particularly when the manifest progressive wasting of the whole 

 system is taken into account. 



Histological examination of the blood after fixatioir and staining 

 will in the former cases reveal the presence of very large numbers of 

 lymphocytes, and in the latter an absolute increase in the number of 

 the mono- and poly- nuclear lymphocytes. It should be easy, therefore, 

 to distinguish the two diseases, especially as other symptoms vary. 



In the earl}' stages leucfemia may be mistaken for the leueocytosis 

 seen in infectious diseases. These fornrs of leueocytosis are verj' com- 

 mon in animals. of the bovine species. They occur in certain forms of 

 tuberculosis, in uterine infections, in cases of internal suppuration, in 

 tumour of the heart, the rumen, etc., and vary in so far as one style or 

 another of white blood corpuscle predominates. The diagnosis, there- 

 fore, necessitates that the white blood corpuscles should be counted, and 

 whenever it is found that their variations in number are no more than 

 between 5,000 and 15,000 per cubic millimetre, the case may be regarded 

 as one of temporary leueocytosis. 



If, on the other hand, those corpuscles number more than from 

 15,000 to 20,000, or, as may sometimes haj^pen, they attain to from 

 200,000 to 300,000 per cubic millimetre (one white to two or three 

 red blood corpuscles), the case is one of leucaemia, and, according to 

 the predominance of the particular type of cell, it is a lympho- 

 cythsemia or a niyelo-cythasmia. 



In leucsemic conditions the red blood corpuscles are also present 

 in fewer than the normal numbers. They are more irregular, assume 

 giant and dwarf forms (macrocytes and microcytes), sometimes exhibit 

 laeunffi, and are always polychromatophile, i.e., without special affinity 

 for any particular constituent of double or triple stains. 



Prognosis. The prognosis of diseases included in the lymphogenic 

 diathesis is extremely grave, and in the present state of our knowledge 

 it may be assumed that sooner or later death is inevitable. 



Treatment. Treatment can scarcely be considered to exist, for at 

 the best it can only delay the development of the disease. Neverthe- 

 less, and with this reservation, it is certain that preparations of iron, 

 iodine and arseiric have a certain effect, probably by acting on the 

 haanatopoiesis. 



