46 



it may be possible to have recourse to complete 

 extirpation ; the modus operandi is as follows : — Cut 

 down on to the lymphatic vessel, and divide it with the 

 actual cautery a few inches above the termination of 

 the cording ; the affected portion of the vessel is then 

 dissected out and removed complete, with the tissues 

 and foci from which the disease is developing ; after 

 which the operation wound is thoroughly cauterized 

 and treated with antiseptics as in the first case. 



In cases where there is diffuse swelling and chronic 

 thickening, surgical intervention is much more difficult 

 and less likely to be attended with success. However, 

 beginning from the periphery, all the affected 

 lymphatic cords should be laid open and treated as 

 above described, all abscesses and pustules should be 

 lanced, their cavities then thoroughly scraped out and 

 afterwards treated with the actual cautery and antiseptic 

 dressing. 



When operation is decided upon, it must be 

 carried out thoroughly, and under strict aseptic 

 precautions, great care being necessary to avoid 

 re-infection through the operation wound. 



Almost every antiseptic and escharotic has been 

 used in the treatment of the disease, and of those 

 generally used I recommend corrosive sublimate in 

 strong solutions, not less than 1-250. 



Internal Treatment 



In this I recommend administrating compounds 

 of iodine and mercury, both of which seem to have a 

 more or less specific effect on the disease, particularly 

 the mercury. 



Corrosive sublimate in doses of half to one grain, 

 in solution or put in the drinking water, or bin-iodide 



