752 
GEO. G. VANDERVEER. 
lated structure of the ribs, the sternum, and the vertebrae, 
the marrow has the same greenish-yellow, purulent color, and 
the same consistency as mucous pus. Under the microscope 
it may be seen that cellular elements of the same nature as 
those occurring in leukaemic blood, form the principal 
constituents. 
The liver is very commonly enlarged, it is pale, smooth, 
lead and retains its shape. The substance is usually firm, of a 
grayish-brown color, or may be marbled. Two chief changes 
have been met with : a diffuse leukaemic infiltration, and nu¬ 
merous small leukaemic tumors. 
The kidneys are usually pale, and often enlarged, the 
capillaries may be distented with leucocytes, and leukaemic 
tumors may be found, generally in the cortex. 
The respiratory system is not often the seat of important 
lesions. Lymphoid growths have been found in the mucous 
membrane of the trachea and bronchi, and occasionally in 
the lungs, where they may closely resemble tubercles, but 
differ from them in having no tendency to caseate or 
soften. 
In the digestive system the stomach rarely presents any 
change other than catarrhal; the intestines have in many 
cases been the seat of tumors which have originated in the 
solitary and agminated glands. In a few cases the bowel 
lesions have been so pronounced that the term intestinal 
leukaemia seemed justifiable. 
The changes in the blood are so characteristic that they 
form the most prominent mark of the disease; the lighter 
color is more and more marked as the disease progresses; the 
increase of leucocytes is continued and progressive, leading 
in its regular progress to the death of the patient. The pro¬ 
portion of colorless corpuscles, finally reached, is very great, 
as high as 1:3 or 1:2. The number of red corpuscles is not 
only relatively but absolutely diminished. The specific grav¬ 
ity is lowered ; the water and fibrine are increased, and iron 
considerably diminished. 
The most prominent symptoms are weakness, exhaustion, 
difficulty in breathing, paleness and emaciation, and profuse 
sweating. 
