GENERAL DISEASES. 109 



Morbid Anatomy. — There is general swelling of the 

 whole limb, the oedema being especially marked above. 

 The subcutaneous tissue and fascia are infiltrated with a 

 yellow coloured lymph, and the tissue itself is hypertrophied 

 and indurated. Similarly the connective tissue among the 

 deeper structures is changed. The lymphatic glands in 

 the affected region are swollen, infiltrated, and hyper- 

 trophied. In chronic cases they are firm and indurated ; 

 in recent ones they may be soft and broken down, forming 

 small abscesses. 



Occasionally the mesenteric glands are enlarged and 

 infiltrated with a gelatinous straw-coloured exudation, and 

 the abdominal cavity may contain a similarly coloured fluid. 



In elephantiasis the skin is thickened, and there is 

 organization of the effused matter. The lymphatic glands 

 in these old standing cases may be calcareous. 



Treatment. — Bleeding from the jugular vein is generally 

 practised in the early stages, though this treatment is not 

 recommended by Professor Williams. Purgatives should 

 be administered in moderate doses, but excess of purgation 

 is to be avoided. Aloes in doses of two to four drachms 

 may be given, or salines may be used. 



Febrifuges are of great benefit in the early stages. A 

 draught of liquor of acetate of ammonia, bicarbonate of 

 potash, nitric ether, and 5 minims of Fleming's tincture of 

 aconite may be administered every four hours. After the 

 purgative has been given, diuretics, to which half a drachm 

 of calomel may be added in cases which have not followed 

 some debilitating disease, may be administered once daily in 

 addition. Tincture of colchicum is recommended by some. 

 The affected limb should be fomented with warm water, 

 and if the pain is severe, tincture of opium may be added 

 to the water, or it may be applied with other anodynes as 

 a lotion after each fomentation. 



