Volume 1
A textbook of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the 8th German edition ... by George H. Humphreys and Charles E. Hackley.
- Felix von Niemeyer
- Date:
- 1880
Licence: Public Domain Mark
Credit: A textbook of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the 8th German edition ... by George H. Humphreys and Charles E. Hackley. Source: Wellcome Collection.
779/792 page 759
![was also diseased, but Virchow saw one case where the spleen was of normal size. I myself have seen a case on which there was no au- topsy, but in which no decided enlargement of the spleen could be observed during life, while the lymphatic glands were enormously en- larged. In all the cases the enlarged lymphatic glands were quite soft and pale, their surface smooth and watery-looking, the cortical substance was particularly swollen, in some cases to the thickness of one-half to three-fourths of an inch ; it had a homogeneous, almost me- dullary, appearance, and, on pressure, evacuated a turbid, watery fluid. ]VIicroscopic examination showed that the enlargement was entirely due to an excessive formation of cells, nuclei, and granules, similar to those occiu-ring in normal glands. In most cases of this disease, the liver was fotmd enlarged; it was occasionally soft, but usually hard and dense. An exceedingly interesting pathological new formation of lymphatic elements, outside of the lymph-glands, has been observed in soms cases of leuchaemia. In two cases, in the parenchjrma of the Uver, and in one case in the kidneys also, Virchow found small white spots, from which, on pressure, there was evacuated a whitish fluid, consisting only of closely-packed free nuclei, and some small cells, which were almost filled by their nuclei. The new formation was enclosed by a fine mem- brane, could be quite readily freed from the siurounding parenchyma, and appeared to come from the walls of the blood-vessels and bile- ducts. JBöttcher observed a similar case. And, in one case of leuchae- mia, Friedreich found extensive proliferation of nuclei and small cells, not only in the liver and kidneys, but also at circumscribed spots in the pleura, and in the gastric and intestinal mucous membrane, which caused partial thickenings of the pleura, and numerous elevations, of varied extent and prominence, in the stomach, small intestines, and rectum. Friedreich also succeeded in proving that the leuchEemic tumors of the pleura and intestinal mucous membrane originated from the connective-tissue corpuscles of those membranes. Syivtptoms and Coijese.—Usually the first symptoms of leuchasmia are swelling of the abdomen, a feeling of pressm-e and fulness in the left hypochondrium, and other signs of enlargement of the spleen. The enlargement has either come on without pain or fever, so that the time of its occurrence could not be dated, or it has taken place at in- tervals, during which there was pain in the region of the spleen, and the patient was feverish. And in the lymphatic form, also, the en- largement of the glands in the neck, axilla, etc., which has taken place slowly, or at intervals, first calls attention to the disease. In a few well-observed cases, which throw a very clear light on the dependence of the dyscrasia on the disease of the spleen and lymphatic glands, it](https://iiif.wellcomecollection.org/image/b20418814_001_0779.jp2/full/800%2C/0/default.jpg)
