216 TIMOTHY EICHARDS LEWIS. 



Manson^ of Amoy, and in Australia by Dr. Bancroft^ of Bris- 

 bane. They have also been found in the blood in Brazil ; and, 

 within the last few weeks, in England, by Dr. Hoadley Gabb of 

 Hastings. 



In considering the possible relation which may exist between 

 the several parasites Avhich have thus been found in different 

 latitudes^ it will be well to bear in mind the history of somewhat 

 similar organisms in the circulation of dogs. There is another 

 matter to be taken into consideration as regards the identification 

 of like parasites in man, — namely, their association with diseased 

 conditions. Are these conditions invariably of the same general 

 character in all countries ? If so, it would be sufficient to show 

 that a distinct relation of some kind existed between the disease 

 and the parasite ; but if it be found, notwithstanding the existence 

 of a general correspondence between them, that nevertheless 

 minor differences were more or less constantly present, this would 

 indicate either that some shght difference existed in the parasite 

 itself or that it bore no causal relation to the disease. 



It so happens that the nematoidhaematozoa are found associated 

 with a disease which, whilst manifesting a close general resem- 

 blance in different countries, is nevertheless characterised by a 

 marked difference. In Asia, or at least in India, this disease is 

 known by its most characteristic appearance, viz. milky or chylous 

 urine; whereas in Africa and South America it is described as 

 the " hsematuria" of various locahties, or as '* hematurie chyleuse '^ 

 or " graisseuse," a term doubtless adopted on account of its being 

 a more correct description of the malady than chyluria. In India, 

 however, although the term may be more or less applicable at some 

 period or other of the disease, it is nevertheless not so appro- 

 priate, in the great majority of cases, and, indeed, in some 

 instances is wholly inappropriate, as occasionally no marked 

 traces of red colouring matter can be detected in the urine from 

 the beginning to the close of the attack. There is an instance 

 of this kind under my observation at present (a European born 

 in the country) suffering from a third attack, who has never 

 detected the slightest trace of blood at any time. It is of im- 

 portance that this feature in the character of the disease accord- 

 ing to its geographical distribution should be borne in mind, as 

 it may hereafter be found that what at present are generally 

 considered as merely two phases of one malady may each have a 

 distinctive etiology. 



1 " Report on Heematozoa," in ' China Customs Medical Reports,' vol. 

 xiii. Shanghai, 1877. 



2 'On Urinary and Renal Diseases,' by W. Roberts, 3rd Edit., 1876, 

 p. 342. 



3 The ' Lancet,' June 22, 1878, p. 921. 



