FILAR I A BANCROFTl 401 



lymphatic vessels (and glands) and the anastomoses of these vessels. 

 We can only briefly summarize our knowledge here. 



We should recall also that considerable destruction or obstruction 

 of lymphatics or glands may occur without necessarily producing any 

 lymphatic obstruction, at least, of a permanent nature, e.g., when a 

 mass of lymphatic glands is destroyed by a bubo in the groin or, 

 again, when a carcinomatous mass of glands is removed from the 

 axilla. Again, to take the case of chyluria where it is generally 

 assumed that obstruction must occur higher up than the point at 

 which the intestinal lacteals enter the juxta-aortic glands this disease 

 may occur, e.g., in temperate regions, quite apart from such obstruc- 

 tion. It is true that some of these cases of chyluria are not cases of 

 chyle in the urine, but, as little or no fat is present, lymphuria. 

 These do not require the above assumption, but seeing that true 

 chyluria may apparently occur without such obstruction, we should 

 be cautious about explaining this and other symptoms on the basis 

 of obstructions which theory may demand, for only too often there 

 are no post-mortem facts at our disposal. 



Lymphangitis : What this is due to is unknown. There is no 

 actual evidence of the occurrence of adults in the inflamed vessel. 

 Complete disappearance, not to reappear, of (non-periodic) mikro- 

 filariae from the blood has been shown by Bahr and others to occur 

 within twenty-four hours after an attack of lymphangitis, orchitis 

 adenitis or simply a high temperature. This mysterious phenomenon 

 requires explanation. If the mikrofilariae were being killed by the 

 attack, their dead bodies should still be found in the blood ; or if the 

 adults were being killed, for all we know to the contrary, the larvae 

 might well survive. We consider there is no evidence that either 

 are affected, but that for some reason, as little understood as in 

 periodicity, the larvae now remain in the organs. 



Abscess : In Fiji, by Bahr, they have been found in the substance 

 of various muscles, e.g., quadriceps extensor, latissimus dorsi, serratus 

 magnus, in the popliteal space, groin, axilla, and over the internal con- 

 dyle of the humerus, and in the upper extremity they are frequently 

 infected with cocci. They not infrequently contain fragments of 

 dead adult filariae. Their mode of origin is not clear. They form 

 nearly 30 per cent, of cases of filariasis in Fiji. Of 95 cases, 41 

 showed mikrofilariae in blood, 54 did not. 



Hydrocele and enlarged testis : In Fiji they form about 10 per 

 cent. (36 out of 343) of cases of filariasis. The fluid is usually sterile ; 

 mikrofilariae were present in the fluid in i out of n cases. In the wall 

 numerous calcified adult filariae may be found. The walls consist 

 chiefly of hypertrophied muscle with fibrous tissue, dilated blood- 

 vessels and lymphatics, the lining epithelium of which appears to be 

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