82 TROPICAL MEDICINE AND HYGIENE 



probably due to the adult worm. The embryos cause 

 no symptoms as far as is known. 



The lymphatics are always dilated where the worms 

 are found, and the commonest lesion to be observed 

 clinically is enlargement of the glands in certain parts 

 of the body, with or without other affections of the 

 lymphatic system. 



In the dilated lymphatics haemorrhage sometimes 

 occurs, so that the whole mass of dilated lymphatics 

 is tense and distended with blood, which coagulates 

 and forms a thrombus. In a portion of such a throm- 

 bus in the groin more than a dozen living filariae have 

 been found. 



As the thrombus becomes organized it is converted into 

 a fibrous mass and completely blocks up the lymphatics. 

 The included filariae probably disappear ultimately in 

 the fibrous mass or become calcified. 



Occasionally, without any haemorrhage, suppuration 

 occurs in the dilated lymphatics with the formation of an 

 abscess. Whether this is preceded by the death of the 

 worm is not known. In the abscesses dead worms only 

 have been found. 



In other cases there is inflammation which has not 

 gone on to suppuration, and in some instances when the 

 inflamed mass has been excised filariae have been found. 

 Calcified filariae have been found by Wise in several 

 regions of the body, and by Bahr in enlarged lymphatic 

 glands. 



These accidents are only diagnosable when the 

 lymphatics in which they occur are superficial, but in 

 chronic cases fibrous masses, probably the remnants of 

 such changes, are found in the pelvis or even in the 

 thoracic duct at a post-mortem examination. 



The glands enlarged may be in one or both groins or 

 in the inguinal canals. These glands are hard and not 

 tender on pressure. Sometimes associated with these 

 enlarged glands is a certain amount of diffuse swelling 

 in the neighbourhood, and comparatively rarely definite 



