284 The Philippine Journal of Science 1921 
orchitis, but the orchitis is secondary; it is not very severe, is 
amenable to treatment, and shows no tendency to recurrence. 
Tendency to recur is marked in the true uncomplicated form. 
In some cases it leaves behind it a thickening of the spermatic 
cord. 
Its pathology is probably the same as that of the other 
diseases in this section; that is, inflammation in an area of lym- 
phatic congestion. In operating on a case of filarial lymphatic 
varix, Moty(88) discovered several soft cysts on the surface of 
the testicle which was enlarged. There was also great thicken- 
ing of the spermatic cord in this case. 
The treatment of the disease is the same as that of ordinary 
orchitis, and strapping should be employed if the case becomes 
chronic. If there is much pain, puncture of the testicle with 
a fine tenotome gives great relief. 
ACUTE ARTHRITIS OR SYNOVITIS 
In cases of erysipelatoid inflammation, affecting a limb, for 
example, it is by no means uncommon to hear a complaint by 
the patient of pain in one of the proximate joints and, on, 
examining the same, to find evidence of some synovitis present. 
As a rule, this synovitis is a negligible quantity and gets better 
without treatment; but in a few rare cases the inflammatory 
process is much more severe. The connection between acute 
synovitis of the knee joint and filarial infection has been pointed 
out by Maitland.(21) My own cases consisted of two kinds. 
a. Cases where the infection almost certainly came from the outside 
and simply fastened itself on a previously inflamed joint. 
b. Cases where the infection was part and parcel of the inflammation 
depending on the presence of the parasite. 
As an illustration of the first kind, the following is of in- 
terest: A man with an old lymph scrotum, who had previously 
had erysipelatoid inflammation of the leg, with accompanying 
pain in the knee, came into the hospital for some troublesome 
internal hemorrhoids, of which I ligatured two masses. He 
was operated upon in the morning. The same evening he had 
a smart attack of erysipelatoid inflammation of the right leg. 
Next morning he was complaining of his knee joint, which was 
distended with fluid. On the following day he was worse, and 
the joint was aspirated and turbid fluid was drawn off. This 
did not clear up the trouble, and two days later the joint was 
