2l8 ELEPHANTIASIS [CH. 



stasis, necessary for the production of elephantiasis, may be 

 due to the blocking of the lymphatic ganglia by the unripe 

 eggs of filariae, expelled from the parent before the embryos 

 are able to uncoil. These eggs are five times as wide as the 

 embryo, and being more or less rigid would be incapable of 

 passing through any lymph glands. This theory accounts for 

 the fact that the filaria embryos are rarely found in the cir- 

 culation of patients affected with elephantiasis. 



The reasons for regarding elephantiasis as a filarial disease 

 are given by Manson as follows : 



" (i) The geographical distribution of Filaria bancrofti and 

 of elephantiasis correspond ; where elephantiasis is common 

 there the filaria abounds and vice versa. (2) Filarial lym- 

 phatic varix and elephantiasis occur in the same district and 

 frequently concur in the same individual. (3) Lymph 

 scrotum, an unquestionably filarial disease, often terminates 

 in elephantiasis of the scrotum. (4) Elephantiasis of the 

 leg sometimes supervenes on the surgical removal of a lymph 

 scrotum. (5) Elephantiasis and lymphatic varix are essen- 

 tially diseases of the lymphatics. (6) Filarial lymphatic 

 varix and true elephantiasis are both accompanied by the 

 same type of recurring lymphangitis. (7) As filarial lym- 

 phatic varix is practically proved to be caused by the 

 filaria, the inference that true elephantiasis the disease with 

 which the former is so often associated and has so many 

 affinities is attributable to the same cause, appears to be 

 warranted." 



On the other hand the filarial nature of elephantiasis is 

 strongly opposed by certain authors, who bring forward argu- 

 ments in support of the view that the disease is caused by 

 bacteria. Le Dantec considers it due to a symbiotic infection 

 with a Streptococcus and a Dermococcus. Dubruel obtained 

 Streptococci in pure culture from cases of elephantiasis, and 

 lately favourable results in the treatment of the disease seem 

 to have been obtained by employing a vaccine prepared from 

 this streptococcus. This author remarks that in the Island of 

 Moorea (Tahiti), where about one- twelfth of the inhabitants 

 shew elephantiasis, he examined the blood of 200 persons 



