Pediatrics : the hygienic and medical treatment of children . miting, occasion-ally with a chill. Pain on mastication, or sore throat and difficultyin .swallowing, are present in some cases. Very soon the gums be-come spongy and begin to bleed, and with the progress of the diseasea general hemorrhagic tendency develops, manifesting itself underthe clinical picture of a hemorrhagic purpura, with petechiae or ecchy-moses in the skin, and hemorrhages from the mucous membranes. 316 Diseases of the Blood Though the cervical lymphnodes may be slightly enlarged, thereis usually no general l>Tnphno
Pediatrics : the hygienic and medical treatment of children . miting, occasion-ally with a chill. Pain on mastication, or sore throat and difficultyin .swallowing, are present in some cases. Very soon the gums be-come spongy and begin to bleed, and with the progress of the diseasea general hemorrhagic tendency develops, manifesting itself underthe clinical picture of a hemorrhagic purpura, with petechiae or ecchy-moses in the skin, and hemorrhages from the mucous membranes. 316 Diseases of the Blood Though the cervical lymphnodes may be slightly enlarged, thereis usually no general l>Tnphnode enlargement in the early stagesof the disease. The tonsils, however, are often enlarged and red-dened, and may be covered with exudate. As the disease progresses,there is often a gradual moderate enlargement of all the peripherallymphnodes, but this may not become notable before death spleen may Aot be palpable in the beginning, but later becomesenlarged to a variable extent. The urine usually shows the char-acteristics of a tubular Acute lymphatic leukemia in a girl of 3^ years, showing en-largement of cervical and axillary lymphnodes, and spleen, andslight enlargement of the liver The Blood.—The chief abnormality involves the w^hite the beginning the white count may be normal, the so-called aleu-kemic stage. Within a few days, the white count runs up to from50,000 to 200,000, and may even reach 500,000. With the increasethere is a remarkable transformation in the differential count, nearlyall the corpuscles being mononuclear basophiles. The lymphocytesusually reach 90 to 98 per cent, and the large lymphocytes are numer-ous, and usually are the predominant form. The remaining 2 to 10 Acute Lymphadenoid Leukemia 317 per cent are mainly polymorphonuclear neutrophiles, with a feweosinophiles. Myelocytes are usually absent. The red corpuscles are normal in number and* appearance in theearly stage. With the progress of the disease a severe
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
