PART III.] The Hcematozoon in Chyluria associated with Leprosy. 523 



in the blood but not in the urine ; as in the former instances, however, there can be 

 little doubt but that had more patience been exercised in the search the results 

 would not have been negative. 



As the case last referred to is one of considerable interest, — Leprosy being by 

 far the most prominent feature in connection with it, — it may be well to allude 

 to it more fully. The urine of one of the prisoners in the Presidency Jail was, 

 about the middle of March 1873, sent to me by Dr. Mackenzie for examination, as 

 pus was suspected. Finding coagula in the fluid, I suspected the case to be one 

 of Chyluria, and proceeded to the Jail hospital in order to make further inquiries, 

 as microscopic examination of the urine had yielded only . negative results. I found 

 that the patient had been a leper for about fourteen years — the disease having 

 come on when he was about 16 years of age, his present age being 30. His feet 

 were swollen, cracked, and almost entirely devoid of sensibility ; ulcers penetrated 

 between the metatarsal bones of each foot ; several of these bones, as well as the 

 proximal phalanges, had become absorbed, and the corresponding toes had been 

 retracted by the tendons in such a manner that the nails barely projected beyond 

 the outline of the body of the foot : his hands were also affected, and altogether 

 he presented a miserable appearance. Nothing wrong, however, had ever been observed 

 in connection with his urine, until about a fortnight before I saw him, when it was 

 seen to become suddenly milky and to coagulate in the vessel. 



Having obtained the foregoing account of his history, I proceeded to examine several 

 slides of blood obtained from his fingers and toes, and readily detected numerous, very 

 active, Filarise. As the man's sentence was just expiring, he left Calcutta for some 

 distant village, so that his subsequent history cannot be obtained. 



The phenomena associated with Chyluria are so well known that it is not deemed 

 necessary to give more than the salient features of the malady, more especially such 

 as are exemplified in the cases referred to in this paper, which, in the main, correspond 

 very closely with the cases that have been from time to time recorded by others. 



In the first place it is to be noted that the malady is decidedly localised as to 

 its origin. As far as I have been able to ascertain, the only cases on record have occurred 

 in persons who have at some period of their lives inhabited the East or West 

 Indies, some parts of Africa, Bermuda, Brazil, or the Mauritius ; so that all writers 

 agree, no matter to what particular cause the disease has been referred, that it 

 is intimately related to a tropical climate. Simple removal, however, from such 

 climate has not sufficed to prevent a recurrence of the disease in England or in other 

 parts of Europe.* 



Secondly, it is noticeable, that the disease, as manifested by the milky appearance 



* I have since observed that Dr. William Roberts, in his well-known work " On Urinary and Benal Diseases " 

 (2nd Edit., pagje B18), records the history of a woman sufEering from Chylous urine who had never lived 

 out of Lancashire. 



