278 The Philippine Journal of Science 1921 
Suppurating hydrocele—A hydrocele of moderate or large 
size is usually already present. At the commencement of the 
attack this swells to nearly double its previous size and becomes 
intensely tender and painful. In a day or so the contents are 
purulent, and if left to itself the wall and skin over it will 
slough and the contents will discharge. A long convalescence 
may ensue, as the opening thus formed may be very large. 
Tapping is of use only in the early stage, and when the contents 
have become purulent, incision and drainage should be employed. 
Care should be taken to have the opening at the most dependent 
» part, and the thick layer of lymph lining the hydrocele sac should 
be removed. Free bleeding will ensue, and the cavity may have 
to be packed for twenty-four hours with gauze. Healing is 
usually rapid, but care should be exercised not to allow the ex- 
ternal opening to close too soon. Strict antiseptic precautions 
should be observed. 
Abscess of the cord.—This is the most serious of the forms 
of abscess affecting the scrotum, by reason of the liability of 
the inflammatory process to spread up the cord. In several 
cases I could trace the cord as a thick, hard rope as far up as 
the internal ring; moreover, it was intensely tender. Whether 
or not in these cases there is any associated inflammation of 
the neighboring peritoneum, there is no positive proof; but the 
fixity and tenderness of that part of the abdominal wall is sug- 
gestive, and it is well known that an acute septic infection of 
the cord may spread inward and set up an acute septic peri- 
tonitis. Although the inflammation in these filarial cases may 
spread up the cord, the actual abscess in all the patients seen 
was outside the external abdominal ring. Abscess of the cord 
is also the most serious of the forms of abscess affecting the 
scrotum as regards treatment. The abscess is apt to have loculi 
and pockets, which interfere with free drainage and, consequent- 
ly, with rapid healing. 
Abscess below the testicle-—This is the simplest of the filarial 
abscesses occurring in the scrotum. Drainage is easy, and heal- 
ing is rapid, a few days sufficing to end the affection, as the 
abscess does not extend far and is not of large size. From one 
of these the portions of a parent worm were obtained, and it 
is possible that all the abscesses in this situation are due to a 
similar cause. 
Filarial abscess of the limbs.—As I have previously stated, 
abscesses of this kind occur in situations rich in lymphatic 
tissue, and generally in the immediate neighborhood of the 
