68 OBSERVATIONS ON FILARI.E. 



(scar is visible), and the same year in the right leg near the ankle ; 

 the whole leg was swollen ; described it as " Toa kha tang " (the 

 expression used to designate elephantiasis). Swelling lasted for 

 one month, and subsided with bursting of the abscess. No thicken- 

 ing of leg now. Scrotal inflammation and fever recurred twenty 

 times a year. A year ago it discharged for the first time ; has run 

 daily, with the exception of three months since that time, messing 

 his clothes. When seen at hospital it had not been discharging for 

 a few hours. Since then (four days ago) it has dripped constantly. 

 In one hour I saw collected two ounces of white fluid. 



*' May 10th, 1879. — This morning I examined the scrotum care- 

 fully. He had it trussed up in a head cloth. On removing this a 

 fine stream of lymph was forcibly projected as from a squirt from a 

 point at the lower part of the scrotum. Half an ounce ran in a 

 couple of minutes. Scrotum is as large as a small pumelo. The 

 skin of the penis is distinctly elephantiased, and a thickening o^ 

 the skin is visible and palpable over both groins, lower two inches 

 of skin of abdomen, and over Scarpa's triangle on both sides. The 

 upper and thigh surfaces of the scrotum are covered with a fine 

 silky skin freely moveable over the thickened substratum ; a little 

 lower down skin thickened and adherent as in elephantiasis ; lower 

 still small ampullae are visible ; lower down these become larger, and 

 along the raphe they are the size of small beans. Pricking any of 

 these the usual fluid escapes. This is most distinctly a case of 

 elephantiasis scroti and Ijmph scrotum combined. Groin glands 

 are large, especially the right, but they do not feel varicose. How- 

 ever, yesterday I pierced the right side glands with a subcutaneous 

 syringe, and readily obtained abundance of straw fluid. In this I 

 found F. S. H., as also in the fluid from the scrotum, and a very 

 few in the blood from finger. While writing these notes more 

 than three ounces of fluid have distilled from his scrotum. 



" Standing, a few ounces of the fluid a feeble coagulum forms, 

 which contracts till, in eight or ten hours, it is one-sixtli the bulk of 

 the fluid. It is now tough and fibrous. A small portion was 

 removed and placed between two glass slides and finally pressed out ; 

 in the fluid expressed and now surrounding, and in the open meshes 

 of the fibrine, are very many specimens of F. S. H. I found none 

 in the serum the clot floated in. It would appear, therefore, that 

 the coagulating fibrine caught the F. S. H., and, contracting, 

 carried, as in a net, all the F. S. H. with it, concentrating them. 

 Some of the FHarice were verv robust and active, others were 



