NEW BOOKS, WITH SHORT NOTICES. 
219 
The structure of the worms is most minutely gone into, and in a 
set of three plates and various woodcuts the author minutely illus- 
trates the subject. With reference to the question whether these 
worms are associated with the so-called chyluria and elephantoid 
conditions Dr. Lewis makes the following observations. 
“ It might be desired that I should express briefly (1) the chief 
reasons for the belief that chyluria and the elephantoid state of the 
tissues, referred to on a previous page, are associated with the pre- 
sence of a microscopic hsematozoon ; and (2) in what manner, such 
connection being satisfactorily established, this fact can aid us in 
offering an explanation of the evidence we possess that the disease is 
due to mechanical interruption to the flow of the nutritive fluid in the 
capillaries and lymphatics : 
“ 1. With regard to the first clause, it may be sufficient to state that 
detailed histories of a considerable number of individuals affected in 
this manner have been published by me, and that in all the Filaria 
sanguinis hominis have been detected. I have now traced the Filaria 
to the blood direct in eleven, and detected them in one or other of the 
various tissues and secretions of the body in more than thirty indi- 
viduals. The history of one of these persons could not be ascer- 
tained, but all the others were known to suffer or to have suffered 
from chyluria, elephantiasis, or some such closely allied pathological 
condition. 
“ 2. With reference to the second clause, our knowledge is not so 
exact, and almost all the inferences have to be drawn from obser- 
vations made in connection with the lnematozoon described in previous 
pages as occurring in pariah dogs. Judging from what may be seen 
in these, and from data which the only post-mortem examinations 
which I know to have been made of individuals affected with this 
parasite, I think that the interference with the flow of fluid in the 
lymphatic capillaries and smaller blood-vessels may not unreasonably 
be attributed to one or other of the following causes : a. To tumours, 
produced by encysted mature entozoa along the course of the blood- 
vessels and lymphatics, impeding the flow of fluid in them by pressure 
either directly or indirectly by interfering with the functions of the 
nerves supplied to the part. b. To the active migration of the imma- 
ture, or rather partially matured parasite ; the act of perforating the 
tissues — nervous or vascular — producing more or less permanent 
lesions, c. To the activity of the liberated embryos in the capillaries 
causing the rupture of the delicate walls of these channels in which 
possibly ova may have accumulated ow'ing to their size, or an aggrega- 
tion of active embryos taken place, either accidentally or by the 
parent having migrated to the capillary termination of a blood-vessel, 
and there given birth to a brood of microscopic blood-worms. Once 
the walls of the capillaries have given way the embryos pass into the 
adjacent lymph channels, the boundaries of which are so extremely 
delicate as practically to offer no impediment to the further progress 
of such active organisms. Should the lymphatic spaces be situated 
in intimate relation with a secreting surface, the escape of the 
minute jilarice , as well as the escape of fluid from the lymphatics 
