2. Lymphatic Type. The changes in this type are chiefly localized in the

lymphatic apparatus, the blood showing an especial increase in those

elements derived from the lymph glands.



Causes--Unknown. It is most common before middle age.



Symptoms. Either type may be acute or chronic. The invasion may be

gradual, sometimes with disturbance of the stomach and bowels, or

nose-bleed. (a) The first type is the common one. The spleen generally

becomes enlarged; it is sometimes tender and painful, it may occupy over

half of the abdominal cavity and varies in size after a hemorrhage,

diarrhea or after a meal. There may be paleness of the face, etc., early

and late nausea, vomiting, diarrhea, and dysentery are common, as is also

ascites (dropsy in the abdomen). The pulse is rapid, full and soft. Fever

is usual. Hemorrhages occur in the skin, retina, pleura, peritoneum, etc.

Headache, dizziness, short breathing, and fainting may occur from the

anemia. The liver may be enlarged. The blood shows a great increase in the

white cells. Sometimes they are more numerous than the red 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.