402 THE ANIMAL PARASITES OF MAN 



absent ; of 38 cases 14 had mikrofilariae in the blood, 24 had not. 

 Most of the cases are associated with elephantiasis of the scrotum 

 (n out of 12 cases). 



Enlarged glands form over 40 per cent. (153 out of 343) of cases 

 of filariasis, so that they are the commonest expression of filariasis 

 met with in Fiji. The glands are enlarged, fibrotic, and the trabeculre 

 are thickened. The lymphatics are thickened or represented merely 

 by fibrous tissue. The gland also shows dilated blood-vessels and 

 numerous spaces filled with lymph. Giant-cells are common in 

 those glands which contain remnants of filariae. Masses of lympho- 

 cytes enclosed by inflammatory or fibrous tissue are common. 

 Eosinophile cells are also extremely common, not only in the fibrous 

 tissue of the glands, but in other inflammatory or fibrotic conditions : 

 in other organs living or calcified filariae are " usually " present. 

 Only about 33 per cent, show mikrofilariae in the blood. The 

 epitrochlear gland is frequently enlarged in Fiji. 



Breinl has examined enlarged glands and finds loose vascular 

 fibrous tissue with lymphocytic invasion. In parts, the lymphocytes 

 collect into areas 200 //, to 800 //, in diameter. The lymph tissue 

 surrounding the spermatic cord showed abundance of vessels 

 {i) large, (2) small. The large had thick walls and wide lumina. In 

 other cases the lumina were nearly filled by a thrombus of newly 

 formed, fine, loose connective tissue. 



Varicose glands : In about ,7 per cent. (24 out of 343 cases) of 

 filariasis, mikrofilariae are found in the blood in 50 per cent. (12 out 

 of 24). 



Elephantiasis. Elephantiasis scroti is associated with hydrocele 

 in 50 per cent, of cases (12 out of 23) ; in 65 per cent, of cases (15 out 

 of 23) there are associated enlarged glands in one or both groins, 

 though also hydrocele and enlarged glands occur without elephantiasis 

 scroti. In 13 out of 27, i.e., about 50 per cent., cases of elephantiasis 

 in various regions, no associated enlargement of glands is found. 

 Elephantiasis forms in Fiji less than 10 per cent, of cases of filariasis. 

 Mikrofilariae are present in the blood in 36 per cent. (12 out of 33) 

 of cases. 



Chylnria Exceedingly rare in Fiji. Theory would demand an 

 obstruction above the point t)f entry of the lacteals, viz., the pre-aortic 

 lymphatic glands, but in cases in temperate regions it may occur 

 without any such lesion. In some of these cases the fluid is not 

 chyle (fat absent), but presumably lymph. A discussion of the mode 

 of production of chyluria, lymph scrotum, elephantiasis, etc., is at 

 present premature ; theory has far outrun fact. Too much stress had 

 been laid on the mechanical action of the worms to the almost total 

 exclusion of their (or possibly their larval) toxic action. The above 



