blood cells.
(b) Lymphatic type is rare, various groups of the lymph glands are
enlarged, usually separate, but sometimes matted together; others, such as
the tonsils may become large. The blood shows an increase of the white
cells, but less than in the other form. The spleen is usually somewhat
enlarged. Recovery is rare; the lymphatic cases may last only six or eight
weeks. The course is usually progressive for two or three years.

Treatment.--The same as for Pernicious Anaemia.

FALSE LEUKAEMIA. (Pseudo-Leukaemia).--Also called Hodgkin's disease,
malignant lymphoma, and general lymphadenoma. This is a progressive anemia
and enlargement of the lymph glands and the skin, with secondary lymphoid
growth in the liver, spleen and other organs.

Causes.--Males are more affected than females, and usually young persons.
Continual local irritation causes a local enlargement of the gland, but
the actual cause is unknown.

[BLOOD AND DUCTLESS GLANDS 253]

Symptoms.--The lymph glands of the neck, arm-pit or groin are enlarged and
without any pain, followed by anemia, loss of strength and slight fever.
The glands enlarge slowly or rapidly, forming large masses, while the
growth extends to other regions. The spleen may be felt; the skin may be
bronzed. In cases with involvement of deep seated nodes the first symptoms
may be those of pressure on blood vessels, nerves, trachea, bronchial
tubes or other structures.

Treatment.--Cut them out if they are small and localized. Arsenic,
quinine, cod-liver oil are good medicines.

PURPURA.--This is not strictly a disease, but a symptom. This includes a
group of affections characterized by hemorrhages into the skin.

Symptoms.--There are hemorrhages into the skin, and this takes the form of
small blood spots underneath the skin, (petechia) and spots like the
bursting of a blood vessel shows vibices or ecchymoses. The first are in
small minute points and appear, as a rule, in the hair follicles and
unlike the erythemas (redness) do not disappear upon pressure. Another
kind occurs as streaks, while the ecchymoses are larger, but similar in
nature to the first kind. They may be larger than a split pea, and they
range from a deep red to a livid bluish tint. They assume a yellowish
brown, then a yellow color, as they fade away and finally disappear. This
eruption appears in a series of crops and the legs are the usual seat.

1. Symptomatic Purpura. (a) Infectious. Occurs in typh