TWO CASES OF LYMPHO-SARCOMA 77 
know, have been made upon the blood, but I should expect a polynuclear leucocytosis of the 
ordinary inflammatory type. 
Lymphatic leukaemia is also a rare disease, and the marked excess of lymphocytes renders its 
diagnosis easy. The glands remain isolated, and the skin is not involved. 
I would suggest that in all cases of general glandular enlargements we should adopt, in 
addition to the routine clinical investigation, a careful blood examination, histological and 
bacteriological, and further, excise a gland, not so much for histological as for experimental 
inoculation. In this way, I think, we may make some progress towards a better knowledge of this 
still vexed question. 
In conclusion, I shall tabulate briefly the points which, in my opinion, should guide us at 
present in grouping our cases. 
Acute tuberculosis of glands. — Matting of the glands, softening thereof and adhesion to the 
skin ; an early and usual course. Leucocytosis of the ordinary inflammatory type. Lesions in the 
skin practically unknown. 
Lymphadenoma . — The glands remain isolated and non-adherent for months and years. 
Blood shows simple ansmia without leucocytosis, except when T. present ; then it is of the 
usual inflammatory type. Skin lesions not known. 
Lymphosarcoma. — Glands soon run together and infiltrate tissues. Leucocytosis of 
mononucleated cells. Skin lesions common. 
Lymphatic leukaemia. — Glands remain isolated, leucocytosis well marked, mononuclear cells. 
In all cases enlargement of spleen, ansmia, haemorrhages, irregular fever, and various other 
symptoms may be present. 
