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to establish the diagnosis. This at that time was almost heresy. I now state that I believe the apparent advantage of arsenic in leukemia and pseudo-leukemia has been in the evident and palpable diminution of the size of the glands, but in the meantime the patient went down hill. I believe arsenic should not be used in this condition.

Physiologically with the above cited case we have the following conclusions:

1st. The lymphocytes are probably not the origin of the polynuclear leucocytes, else with SO many lymphocytes we ought to have an increase of the more mature cells.

2nd. Normally, without medication to cause it, in lymphatic leukemia, as has been observed by others as well as ourselves, the uric acid and phosphorus output is not increased, hence these cells do not break down more rapidly than in normal individuals with only eight thousand or so leucocytes. This means that a normal person with from five to eight thousand leucocytes has no more nuclear break-down than these patients with nearly four hundred thousand leucocytes.

3rd. Arsenic, alkalies and nucleic acid reduced the size of the glands and spleen in this case but caused destruction of red corpuscles.

4th. Nucleic acid alone seemed to positively reduce the number of the white cells.

5th. The red cells and the general condition always and consistently improved under Armour's red bone marrow. Hence it is justifiable to assume that in this case, if not in all cases of lymphatic leukemia, the bone marrow is diseased.

6th. The malarial infection reduced the number of the white cells and the size of the glands more than any treatment instituted.

BIBLIOGRAPHY.

1. Moore, Buck's Reference Hand Book of the Medical Sciences, New Series, Vol. II.

2. Warthin, Journ, of Boston Med. Sci., Vol. V, Nov. 9, 1901. Rubinstein, Zeitschrift f. klin. Med., Bd. XLII, Heft 3-4. Josue, Revue de Medicine, Dec. 10 1900.

3.

4.

5. Hannes, Centralbl. f. innere Med., Aug. 24, 1901.

6. Stassano, La Semaine Medicale, July 17, 1901.

7. F. B. Mallory, Trans. Asso. Amer. Phys., 1900.

8. Becker, Deutsche Med. Woch., Aug. 30, 1900.

9. Heim, Archiv. de Medecine des Enfants, Jan. 1901. Osler, Practice, p. 803.

10,

11.

Virchow

12. Neumann)

Cited from Jewett, Phil. Med. Journ., Apr. 27, 1901.

13. Sternberg, Archiv. fuer Heilkunde, Vol. XIX, p. 21. 14. Musser, American Medicine, Jan. 4, 1902.

15. Wende. Amer. Journ. of Med. Sci., Dec., 1901, p. 836.

16. Rosenfeld, Zeitschrift fuer klin. Med., 1900.

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