74 THOMPSON YATES LABORATORIES REPORT 
Leucocytes are mainly small lymphocytes. Eosinophil cells not excessive. 
He was put on liq. arsenicalis w iii thrice daily after food, and this was gradually 
increased until, on October 9th, he was taking 12 minims thrice daily. 
During this time he seemed to improve, the glands becoming smaller and softer, and the 
rash fading. 
On October 15th some oedema of limbs and scrotum was observed, also slight albuminuria. 
The temperature rose to 103*^. No rigour. The arsenic was omitted. It is noted on the 17th 
that he passed 172 oz. of urine without albumen. 
A syringeful of blood was taken from a superficial arm vein, and a free growth of staphy- 
lococci was obtained. Blood now R.C. 3.5 million, Wh.C. 14,000, mainly polynuclear. On the 
22nd the T. was again normal. 
During the attack of fever the diminution in the size of glands was most marked, and far 
surpassed the slight change resulting from the exhibition of arsenic. He had a second febrile 
attack on November 8th lasting until November 15th, when blood showed R.C. 4,500,000, 
Wh.C. 25,000, still polynuclear in the main. 
On November i8th glands again enlarging. 
Without giving full details, I may say that the glands slowly increased, the rash became 
again prominent, and the dyspnoea severe. On December 8th the R.C. were 3,500,000, the 
Wh.C. 50,000, still mainly polynuclear. 
He unfortunately contracted measles and died. 
P.-M. — The lymphatic glands in the situations noted during life are greatly enlarged. In 
the mediastinum the glands are fused together, as is the case also in the lumbar glands. The 
spleen is enlarged, no nodules present. Nodules of growth are present in the liver and kidney on 
microscopical examination. 
The bone marrow is normal. 
The mucous membrane of the larynx and trachea shows a uniform thickening ; in the 
arytaeno-epiglottidean folds are two localized nodules the size of peas. 
Histological examination of the lymphatic glands reveals an increased stroma, an 
accumulation of lymphoid cells, occasional giant cells, but no signs of necrosis. Eosinophil 
cells are present in some number. 
Case II 
Henry K., aged 28, porter, was admitted under my care on February i8th, 1898, 
complaining of cough. There is no special point in the family history. Has always been 
healthy. No history of venereal disease. His fatal illness began with a dry cough about Christmas, 
1897, and the enlargement of the glands was first noticed in January, 1898. He is thin, ears 
cyanotic, cheeks flushed, skin over chest oedematous, temp. 100". 
The glands on both sides of the neck, the suboccipital glands, the axillary and inguinal 
groups are enlarged ; in part the glands are fused, and somewhat fixed on the deep tissues. In 
one area a gland has become adherent to the skin, which is reddened. 
