Hodgkin's Disease: Pathological Aspects

of remission, especially in the early stages of Hodgkin's disease, and has reduced pressure symptoms, and so rendered the remaining span of life not only longer but more endurable. I have repeatedly seen a localized focus of lymphadenoma tissue completely disappear under X-ray treatment and pressure symptoms relieved. But in spite of local success, recurrences sooner or later occur in the same area or in other regions, and with each recurrence the interval of remission becomes shortel and the fresh glands more resistent to irradiation. The failure to maintain the early success in the later stages is most disappointing. However, the difficulties of the radiologist seem to me almost insuperable. The wide dissemination of the disease throughout the thoracic and abdominal cavities militates against a dosage adequate to cause regression of all the affected nodes. The greatest success has been in cases where the disease is caught in its early localized condition in the neck. Unfortunately, this stage is too rarely diagnosed; most of our cases have advanced well into the generalized stage before treatment has been instituted. Enlarged glands in any part of the body demand urgent and exact diagnosis, and their successful early recognition is of special importance in Hodgkin's disease, if the unfortunate patient's only hope is not to be sacrificed. Between the intervals of X-ray treatment, arsenic should be pushed, either in the form of Fowler's solution, sodium cacodylate, or nov-arseno-billon. To the knowledge of this disease first described by Hodgkin while working as a morbid anatomist, clinicians have added but little. It has gradually been isolated from a scrapheap of allied conditions, chiefly by the advance of pathological technique. To the pathologists we turn hopefully for further light on its causation, with a lively faith that the elucidation of this strange intermediate disease may be the stepping-stone to the solution of the infinitely more pressing problem of malignancy.