286 The Philippine Journal of Science 1921 
GANGRENE OF THE SCROTUM 
Gangrene of the scrotum is not a common disease, especially 
if all cases of nephritis are excluded. Its occurrence in a healthy 
young man is sufficiently remarkable to call for special notice. 
Table 7 gives particulars of 8 cases seen during four years. 
TABLE 7.—Cases of gangrene of the scrotum. 
Initials. Age. Evidence of filarial disease. ae 
Years. 
4 Sc bean a aD 40 | Filarial embryos and varicose groin glands____-______________- Yes. 
2 sg Rent 43 | Old elephantoid fever; no embryos found .._----.--_._ _..-_-- Yes. 
Pe FIG eaten 23 | Varicose groin glands; fever; no embryos found ____._.-.------ Yes, 
We hs Oe abe 85 | Elephantoid fever and occasional swelling of scrotum; no em- | No. 
bryos found, 
So rae eee pd 41 | Varicose groin glands; elephantoid fever _.___.________.______. Yes. 
Onk. seis 41 | Elephantoid fever; no embryos found_____-_____________.-___-- No. 
ee ee 87 | Varicose groin glands; no embryos found _____.___--_-----__-. Yes. 
| s Sige iss 88 | Elephantoid fever for many years; no embryos found _________ No. 
* Slight erysipelatoid inflammation of the scrotum accompanying attacks. 
The only common feature in these cases is that all had a history 
of filarial disease, past or present. They began in the same 
way; that is, with a sharp attack of fever, accompanied by 
redness and swelling of the lower half of the scrotum. This 
inflammation is from the first acute, and in a few days the lower 
half of the scrotum becomes black and comparatively dry. If 
left to itself, this gradually separates, and the exposed surface 
slowly heals. Healing may be hastened by skin grafting as 
soon as the surface is covered by healthy granulations. 
Hydrocele, if present, may materially hinder the healing of the 
wound, and it must be tapped. If this is done with strict anti- 
septic precautions, there need be no fear of infecting the hydro- 
cele. It should be tapped, of course, through healthy skin and not 
through the granulating surface. 
It may be urged that these were malarial cases. While it is 
true that malarial gangrene is a well-known affection, in all 
these cases no evidence was obtained that would support this 
contention. Although none of them had been treated with qui- 
nine, the microscopical examination of the blood was entirely 
negative. J 
One point is worthy of note; namely, that of the eight cases 
only two had filariz present in the blood. It is possible that in 
all such cases, however, the parent worm is present in the tissues 
