BANTI'S DISEASE 381 



The most useful remedial measures for the latter purpose are tonics and 

 rohorants, and chiefly the preparations of iron and quinin. Arsenic when 

 properly used has a tonic effect, and so improves the nutrition that if it is 

 administered internally other remedial agents may be dispensed with, or sim- 

 ply combined with arsenic. Lately a combination with ferrum cacodylicum 

 in doses of 0.25-0.3 gram daily has been advised according to the following 

 prescription: Ferr. cacodyl. 1.0, Aqu. cinnam. 25, of which 20 to 40 drops 

 are taken three times daily. 



I need hardly say that in every dietetic and drug treatment attention to the 

 digestive organs is of great importance, and if these show any disturbance of 

 function, amelioration must here be first attempted. 



It is also self-evident that febrile conditions or possible complications are 

 to be treated according to their special indications. [The X-ray treatment of 

 Hodgkin's disease seems at this time to promise more than any other. The 

 number of cases is not large, but the results are often favorable. The technic 

 is very simple; the affected glands are exposed to the X-ray for as long a 

 period (every day or every second day) as the skin will stand without sustain- 

 ing any " blush." Pressure symptoms due to substernal glands have thus been 

 very notably relieved. — Ed.] 



BANTI'S DISEASE 



We turn now to the description of the second form of pseudo-leukemia, 

 the lienal or splenic variety, in which enlargement of the spleen is predomi- 

 nant or apparently occurs alone, i. e., without glandular enlargement. I say 

 apparently, for, according to my investigations, the lymph-glands are almost 

 always implicated. It is true that sometimes the enlargement affects only the 

 deeper ones, particularly those glands situated in the abdominal cavity, and 

 therefore recognizable only at autopsy. There are numerous cases, as I have 

 mentioned previously, in which the spleen and lymph-glands are attacked 

 simultaneously, and these cases are designated as pseudo-leukemia lymphatico- 

 lienalis, and constitute a transitional stage between the two other forms. 



Aside from the glandular swelling and the course of the disease the clinical 

 picture in the lienal form scarcely differs from that of the lymphatic form 

 (Hodgkin's disease), and the description may consequently be brief. 



Besides the enlargement of the spleen, or even before this becomes notice- 

 able, the earliest symptom is anemia, and Gretsel (Griesinger) has therefore 

 designated the disease as " splenic anemia." But this name is not distinctive 

 for, as later researches have shovra, the blood finding does not, or at least not 

 always, correspond morphologically to that of simple anemia. On the con- 

 trary, manifold changes, particularly in regard to the number and proportional 

 relations of the leukocytes, are met with, but never such a decided increase as 

 in leukemia. At one time the blood may, in fact, resemble simple chronic 

 anemia, i. e., the number of erythrocytes may be more or less decidedly de- 

 creased, the hemoglobin to the same degree or even more decidedly diminished, 

 and the proportion of leukocytes to erythrocytes, although varying not mark- 

 edly, exceeds normal limits. [The very low color-index has been especially 



