causes death in from twelve to eighteen months.

[Illustration: FIG. 81.--Lymphadenoma (Hodgkin's Disease) affecting left
side of neck and left axilla, in a woman aet. 44. Three years' duration.]

In the acute form, the health suffers, there is fever, and the glands
may vary in size with variations in the temperature; the blood presents
the characters met with in secondary anaemia. The spleen, liver, testes,
and mammae may be enlarged; the glandular swellings press on important
structures, such as the trachea, oesophagus, or great veins, and symptoms
referable to such pressure manifest themselves.

_Diagnosis._--Considerable difficulty attends the diagnosis of
lymphadenoma at an early stage. The negative results of tuberculin tests
may assist in the differentiation from tuberculous disease, but the more
certain means of excising one of the suspected glands and submitting it
to microscopical examination should be had recourse to. The sections
show proliferation of endothelial cells, the formation of numerous giant
cells quite unlike those of tuberculosis and a progressive fibrosis.
Lympho-sarcoma can usually be differentiated by the rapid assumption of
the local features of malignant disease, and in a gland removed for
examination, a predominance of small round cells with scanty protoplasm.
The enlargement associated with leucocythaemia is differentiated by the
characteristic changes in the blood.

_Treatment._--In the acute form of lymphadenoma, treatment is of little
avail. Arsenic may be given in full doses either by the mouth or by
subcutaneous injection; the intravenous administration of neo-salvarsan
may be tried. Exposure to the X-rays and to radium has been more
successful than any other form of treatment. Excision of glands,
although sometimes beneficial, seldom arrests the progress of the
disease. The ease and rapidity with which large masses of glands may be
shelled out is in remarkable contrast to what is observed in tuberculous
disease. Surgical interference may give relief when important structures
are being pressed upon--tracheotomy, for example, may be required where
life is threatened by asphyxia.

#Leucocythaemia.#--This is a disease of the blood and of the
blood-forming organs, in which there is a great increase in the number,
and an alteration of the character, of the leucocytes present in the
blood. It may simulate lymphadenoma, because, in certain forms of the
disease, the lymph glands, especial