28o DISEASES DUE TO HELMINTHS 



(3) The condition may be caused by a blockage of lymph channels 

 of the diseased area as a result of the frequent and prolonged invasion 

 of the adult filaria. The microfilariae may not reach the blood but they 

 may die in the gland. The periodic discharge of these microfi]ari£e may 

 be a factor in producing lymphangitis, orchitis and funiculitis, the 

 parent worm dying as a result of these inflammatory attacks (Bahr). 



In these conditions the blood is usually normal. 



There is often secondary anaemia in haemato-chyluria and diarrhoea. 



Sometimes there is leucocytosis during the febrile period. 



The eosinophiles at times may be increased in blood examinations. 



P.M. 



The findings are according to the variety of the lesion. 



In Lymphangitis the lymphatic vessels are enlarged and inflamed 

 with cyst-like dilatations and the walls are thickened and fibrous. Abs- 

 cesses, varying in size, may contain dead worms. These dead worms 

 ma\' become calcified ov the calcareous deposit may be gradually 

 absorbed until onl}- minute yellow spots remain. The worms, calcified 

 or living, are surrounded by eosinophilic cells in large numbers. 



Filarial abscesses have been found in the gastrocnemius muscle, 

 popliteal space, groin, quadriceps muscle, over the internal condyle of 

 the knee, in the axilUe, latissimus dorsi and the serratus magnus 

 muscles, and in the subcutaneous tissue. 



In the abscesses are also found Staphylococcus pyogenes aureus and 

 Streptococci pyogenes. 



In Lymphatic varicosity the vessels are much dilated with thickened 

 walls. The glands are dilated, the true gland tissue disappears leaving 

 a fibrous sac with numerous septa. 



In Elephantiasis, the vessels are dilated and thickened in early cases. 

 There is a round celled infiltration into the connective tissue of the part, 

 leading later to the hvpertrophv of the connective tissue of the skin and 

 fasciae, this latter including that of muscles, vessels and nerves. 



All the tissues are sodden with lymph. 



The muscles show fatty degeneration. 



The bones are thickened or perhaps covered with osteophytes or 

 more rarel}- are atrophied and still more rareh- are invaded bv caseous 

 abscesses. 



CLINICAL VARIETIES. 



(1) FILARIAL LYMPHANGITIS.. 



DEFINITION. 



An inflammation (jf the lymphatic vessels in anv part of the body 

 caused b\- Filaria bancrofti. 



