PART III.] Association of Chyluria with other Morbid Conditions. 525 



resided in them, appear to indicate that the disease is, probably, not dependent on such 

 mechanical or pathological causes as these.* 



The same remarks apply to the etiology of the various other phenomena enumerated 

 as the more or less frequent concomitants of Chyluria, without much modification ; for 

 even should actual rupture not take place, local congestions may be induced, or very 

 trifling fissures, which might yet be sufficient to interfere with the functions of 

 delicate organs, or it may be, as in the case of the eye or ear, that the mischief 

 may be chiefly due to some changes induced in the refractive media of the former, 

 or in the fluid in contact with the nerve filaments in the latter. 



The intestinal affection, if in reality connected with the entrance or exit of 

 these Filarise, deserves special attention. The only known symptom from which the • 

 man in whose blood this helminth was first discovered, was severe diarrhoea ; the 

 commencement of the illness of another man is dated from a similar attack, which 

 developed itself into what is described as " chronic dysentery," on which the usual 

 medicines appear to have had no influence, for during the last five years the disease 

 came and went without reference to medical treatment — the chylous condition of the 

 urine having been equally irregular in its appearance and disappearance. It will be 

 remembered that the intestinal affection commenced eight months before the urinary 

 symptoms appeared ; moreover in the woman whose autopsy has been recorded on a 

 previous page, " tubercular like " ulcers were found in the intestines, as also in the 

 lungs. All these occurrences, especially when taken in connection with what is 

 known to occur in connection with the migration of several parasites, are too 

 prominently associated with the history of the cases in which these Hsematozoa were 

 detected to permit of the subject being passed over without comment. 



With reference to the " granular-lid " condition of one of the patients affected 

 with Hsematozoa, it has been demonstrated, since the earlier pages of this paper were 

 in type, that not only had congestion resulted from the presence of the Filarise, but 

 actual rupture and escape of one of them at least occurred, either through the channel 

 of the lachrymal, or of a Meibomian gland. 



In continuation of the subject of the association of Chyluria with other diseased 

 conditions, the following particulars obtained since the original publication of these 

 observations may be of interest: — Towards the end of the year (1873), Dr. Ewart 

 forwarded to me for examination a sample of whey-like urine, obtained from a man 

 suffering from a scrotal tumour, with the request that I would state whether I 

 considered that the fluid should be looked upon as " Chylous urine." Although 

 highly albuminous, it did not show any tendency to coagulate spontaneously, so 

 it was thought better to wait for more samples. Dr. Ewart very kindly took me to 

 see his patient — a Jew — who had suffered from scrotal enlargement for many years, 



* Dr. W. J. Palmer has, quite recently, published some highly interesting cases bearing on this subject in ' 

 The Indian Medical, Gazette (Vol. VIII, 1873). 



