PART III.] Filaria Sanguinis Hominis in Relation to " Chyhiriar 567 



On pricking her finger with a needle and distributing a drop of blood over 

 several slides, I found that the Filarise were present in it also. 



She remained under observation for a period of about two months, but there 

 was no marked change in her general condition ; her face, however, became swollen 

 on one or two occasions, and appeared puffy, as also did the upper and lower extremities. 

 The urine slightly improved in appearance, and the numbers of the Filarise in it as 

 well as in the blood diminished ; in the latter especially, at all events, the numbers 

 obtainable by pricking the fingers or toes certainly decreased ; and eventually, out 

 of half-a-dozen or more slides not more than one or two Hsematozoa could be detected : 

 on a few occasions several slides were examined without any being found. 



The patient, however, could not be persuaded to remain longer in hospital : indeed, 

 all patients thus affected soon get tired of being treated for their complaint, as there 

 is seldom any great suffering which the patient can directly connect with this condition, 

 and often no other very well-marked symptom, beyond general debility. 



As all the female patients suffering from Chyluria, brought to my notice, had 

 been under middle age, and the disease had seemed somehow to bear a sort of ill- 

 defined relation to pregnancy or nursing, I was glad of the opportunity of examining 

 a woman who for some ten years had ceased to menstruate : for this opportunity 

 I am indebted to Dr. Charles Macnamara. The woman was a housekeeper, aged 52, 

 the mother of six children, of whom two are living. She first observed her urine to 

 present a milky appearance four years ago; the disease came on suddenly, and lasted 

 about a month. It reappeared without any preliminary symptoms a year and a half 

 afterwards, and again during the summer of 1873. A drop of blood, obtained by 

 pricking one of her fingers, was distributed over some half-a-dozen glass slides, and 

 forthwith examined, the result being that two out of the six preparations contained 

 specimens of the Filarise ; so that in women also, other than child-bearing disturbances 

 may determine an attack of Chyluria. Dr. Macnamara informs me that he knows 

 of a little girl, quite young, who is subject to similar attacks. 



The most remarkable case which has come under my notice, in which the blood 

 was affected in this manner, was that of a patient in one of Dr. Ewart's wards, whom 

 he kindly placed at my disposal for observation and treatment. The man was an 

 East Indian (with more of the habits of the native than of the European), about 

 22 years of age; he had been for about five years employed as cook on board one 

 of the light-ships lying at the entrance of the Hooghly, spending only about three 

 months of the year with his family on shore. 



The prominent symptoms in this case were, extreme and persistent milkiness 

 of the urine, which coagulated with great rapidity after being voided. On being 

 heated the smell given off at first corresponded exactly with that of warm milk, 

 but when the heat was continued for some time, was gradually replaced by the ordinary 



