Elephantiasis

Tli is affection is characterized by great hypertrophy of the integument of either the leg or scrotum in men, or leg or labia in women, or both locations may be involved at tlio same time. It occurs frequently in tropical countries, but rarely in northern climes.

In the development of this disease general symptoms precede the local ones, and the first indications are usually a sharp, febrile attack, in no way distinguishable at the beginning from an ordinary severe paludal fever. In a few days, however, pain in the groin, with swelling of the lymphatics, is noticed, and this in turn is followed by more or less oedema of the foot and leg. After the subsidence of the febrile attack the oedema of the limb abates, but does not as a rule wholly subside. After a varying and uncertain interval a second febrile attack occurs, with renewed swelling of the limb, which but partially subsides, leaving the part still a little larger than before. These attacks succeed each other irregularly over several years, until finally the leg or other part affected may attain an enormous size.



Elephantiasis is unquestionably due to obstruction of the lymphatic circulation; and this in turn has been most conclusively proved in many cases to be due to the presence of a minute worm, the filaria sanguinis, 'which lodges and excites inflammation in the lymphatic glands and produces occlusion of the vessels. The febrile attacks, which occur with a certain periodicity, may be due to the development of fresh broods of filaria. This parasite, however, is not met with in the higher latitudes, in which cases of the disease are sometimes encountered; and hence these latter need some other reasonable explanation, whichwe regret to say is not forthcoming. It is supposed by some that the mosquito plays an important part in the development and transportation of the undeveloped filariae.

Elephantiasis is always a grave disease, and may last a life time.