272 The Philippine Journal of Science 1921 
Should the inflammation proceed farther, a severe cellulitis may 
ensue, or lymphorrhagia may take place. 
As a rule the inflammation subsides under appropriate treat- 
ment, leaving behind, however, a legacy in the shape of some 
permanent thickening. This thickening is variable in amount, 
and it is almost impossible to predict in any given case what 
measure of thickening will be left. 
The area of inflammation is sometimes very extensive. In 
one case the lymphatics of both cords, superficial lymphatics of 
the scrotum, and the lymphatics of the upper parts of both 
thighs were affected, and the condition of the patient was by 
no means enviable. But in other cases the inflammation of the 
lymphatics is confined to a very narrow area. In the upper 
arm this is often the case, and the inflammation in one patient 
was confined to an area less than 2 inches (5 centimeters) in 
length in the region of the brachial artery. 
I have seen filarial fever without manifest lymphangitis; I 
have never seen filarial lymphangitis without fever of greater 
or lesser degree. 
Diagnosis is easy, as a rule, as the absence of local cause 
and the presence of filariz in the blood are readily determined. 
If there is a manifest possible local cause, it is sometimes dif- 
ficult at first sight to be sure, but before long the course of 
the case gives clear indication, 
As to treatment, rest, lead and opium ae and the treat- 
ment previously Rdvised for elephantoid fever quickly clear up 
the trouble. 
If the attack fails to resolve, a careful watch must be kept for 
the formation of abscess. It has been recommended that the 
swollen area should be scarified or pricked. Experience leads 
me to advise strongly against this procedure. It is extremely 
difficult to keep the parts about the scrotum, especially in 
natives, aseptic; and it is quite possible to start a most trouble- 
some lymphorrhagia. In a few cases, after the inflammation 
has subsided, it may be advisable to dissect out the thickened 
lymphatics, and sometimes in this way it has been possible to 
secure the parent worm, which by its presence may have given 
rise to the lymphatic inflammation. 
ERYSIPELATOID INFLAMMATION 
It becomes necessary to use a name such as erysipelatoid to 
describe erysipelatoid inflammation, for the term “erysipelas” 
would convey a false idea. While it is no doubt true that the 
superficial resemblance between this affection and erysipelas 
