DIAGNOSIS. 145 



that tlie case is not one of acute farcy ; for we know well 

 enough that in some developments of farcy the only abnormal 

 features for a few days are not diagnostic, being merely such 

 as we have noted as existing in lymphangitis — viz, pain, 

 swelling of the limb from infiltration, and it may be indurated 

 and swollen glands. Very shortly, however, if the case is one 

 of farcy the diagnostic lesions will become manifest : farcy- 

 buds will appear and steadily pass through their different 

 changes, terminating in ulceration with its specific characters. 

 Should the general tumefaction and inflamed state of the 

 lymph vessels and glands be only that of the commonly occur- 

 ring and benign affection, they will, in something like the same 

 time, gradually subside, together with the accompanying fever 

 and pain, and certainly without the formation of farcy-buds, or 

 tumours, or the existence of chancrous ill-conditioned sores. 



This subsidence of the symptoms of illness and a return to 

 health will be expedited by a course of treatment which, if 

 the oedema and pain were the concomitants or precursors of 

 farcy, would in all likelihood hasten the production of the 

 specific and diagnostic lesions, the growths and ulcers. When 

 ' lymphangitis ' is due to wounds of the limb, which may exist 

 either in the superior, but more frequently in the inferior part 

 of the member, the general symptoms and indications of irrita- 

 tion, with the swelling from infiltration, the result of the in- 

 flammatory action, and the corded, full, and sharply defined 

 condition of the lymphatics, together with the fact that a 

 wound exists, which may probably, at the period of inspection, 

 not be of a remarkably healthy character, all tend to give a 

 certain feasibility to the suspicion that the case is one of farcy. 

 The absence, however, of specific growths on the course of the 

 lymphatics, which are not bulged or knotted as in farcy, with 

 probably the history of the wound, and the fact that only one 

 exists, as also its character and the obvious efiect which a 

 moderate amount of soothing treatment will produce on its 

 condition, in a very few days afford substantial evidence that 

 no farcy exists. 



In the chronic manifestation of lymphangitis, or rather, it 

 should be said, in that peculiar diseased condition of the sub- 

 cutaneous connective-tissue consequent on repeated attacks 

 of ordinary lymphangitis, and known as elephantiasis, when, 



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