LEUKJ5MIA. 
751 
It attacks all ages, but males are more prone to its ravages 
than females in the proportion of at least 2 to 1. 
It is more common among the poorly housed and fed 
than among those who enjoy better sanitary surroundings. 
Previously existing diseases may have an effect in producing 
the disorder, prominent among which is mentioned malaria, 
while pre-existing hemorrhages, and injuries from blows and 
strains are frequent in the histories of cases. 
There is extreme wasting, oedema is common, and ascites 
may often be present. The full amount of blood in the heart 
and blood vessels, usually in the form of large clots, is a note¬ 
worthy feature, and the collections of white cells densely 
inhitrating these clots, present a pus-like appearance. 
In the majority of cases the spleen is hypertrophied, the 
splenic tumor is always of considerable size, and generally 
retains its normal form, developing proportionally in all its 
dimensions It is usually bluish-red in color, and may be 
united to the abdominal wall, diaphragm or stomach by 
strong adhesions. The capsule is thickened and the vessels 
enlarged. The organ is hard and firm and cuts with resist¬ 
ance, and grayish-white granulars tumors may occur either 
scattered about or arranged in rows throughout its w-hole 
<=> • . . => 
extent. In the early stages there is swelling of the pulp and 
increase in the cell elements without the firmness and hard¬ 
ness of the fully developed leukasmic organ, and at this 
period rupture may occur. 
Uncomplicated cases of the lymphatic form are rare, usu¬ 
ally the lymphatics enlarge with the spleen and in the major¬ 
ity of instances the hypertrophy is not extensive. The process 
seems, just as in the spleen, to begin with a greater flow of 
blood, and an increased vascularization, under the influence 
of which the multiplication of glandular elements takes place. 
The groups of cervical, axillary, mesenteric, and inguinal glands 
are the most frequently affected; they are moderately soft, 
movable, and isolated; in chronic cases they may become 
very indurated. 
The bone marrow is usually the seat of important changes, 
both in the central cavity of the long bones, and in the cancel- 
