86 TROPICAL MEDICINE AND HYGIENE 



of coagulum only are formed. Shaken up with ether the 

 urine becomes clearer as the fat globules are dissolved, but 

 some turbidity always remains. When examined micro- 

 scopically finely divided oil globules are found throughout 

 the urine in many cases, and blood corpuscles if blood is 

 abundant. 



Some authorities dispute the presence of actual blood, 

 and point out that chyle in the lymph-vessels is often 

 pinkish, and that this tinge is often deeper when the 

 lymph has been prevented from escaping from the 

 lymphatics. This change may be the cause of the pink 

 tinge of some chylous urine, but does not account for the 

 coagula of blood, indistinguishable from ordinary blood r 

 in other cases of chyluria. 



Chyluria indicates rupture of dilated lymphatics in some 

 part of the urinary tract and obstruction of the thoracic 

 duct. 



Chylous ascites is rare, but does occur in filariasis. In 

 this case rupture of the lymphatics into the peritoneal 

 cavity takes place. 



Hydrocele is so common an infection in the Tropics 

 that one is tempted to consider that filariasis may be to 

 a large extent responsible for the frequent occurrence of 

 this condition. In a few cases it is so, as the fluid is 

 chylous and contains filarial embryos, and in others, 

 even when the fluid is not chylous, filarial embryos are 

 present. Calcified adult filaria may be found in the wall 

 of the hydrocele. Sometimes the hydrocele is associated 

 with other evidence of lymphatic obstruction. A certain 

 proportion of the cases of hydrocele may be referred to- 

 this cause, but it is probably a small proportion only. 



In such manifestations as lymphatic varix, chyluria, 

 haematochyluria, and lymph scrotum, the association with 

 filarial infection is undoubted, and with a proportion of 

 the cases of enlarged glands and hydrocele it is equally 

 so. 



The local chronic swellings of limbs, scrotum, breast, 

 and patches of skin known as elephantiasis are clearly 



