26 A Hcematozoon in Human Blood. [part hi. 



but whose urine had never manifested this turbid appearance till four days previously. 

 The urine voided in my presence was more distinctly milky, and a few coagula were 

 observed, so it was determined to make a search for Filariae — especially as Dr. Ewart 

 was anxious to ascertain as far as possible whether the albuminuria was necessarily 

 dependent on organic disease of the kidneys, the friends being very desirous that 

 the scrotum should be operated upon. I brought away two samples of urine with 

 me, but it required jive hours of steady application to the microscope before a single 

 specimen was found ; specimens were however subsequently found in both samples 

 of urine. The diagnosis having thus been satisfactorily established, the operation was 

 carried out. Dr. Ewart promises to publish all the particulars of the case before 

 long, as it embraces some other points of considerable interest.* 



It will be observed that the foregoing case, as well as the case cited in which 

 Leprosy was succeeded by Chyluria (page 523), bear out, in a marked manner, the 

 importance of the inference which I felt that I was justified in drawing when this 

 report was submitted to the Grovernment in 1872, viz., that the milky condition of 

 the urine is to be looked upon as one of the symptoms of the presence of Filariae in 

 the system. I felt persuaded at that time that some of the unhealthy conditions 

 observed among persons residing in tropical climates, especially those apparently implying 

 abnormalities in the lymphatic system, would, at some future period, be found to be 

 intimately associated with some such parasitic condition as this. With a view of eluci- 

 dating this as far as possible, I have availed myself of every opportunity of examining 

 all manner of fibro-albuminous exudations which have come in my way. Whilst the 

 re-issue of this paper was being printed off, a case still more confirmatory of the 

 opinion then expressed has come under my notice, for the opportunity of investigating 

 which I am again indebted to Dr. CouU Mackenzie. 



The patient was an East Indian, 35 years of age, had lived in India all his life, 

 and had been in the enjoyment of fair health until about 9 months ago, when he 

 observed that his scrotum was enlarging. He was several times tapped for hydrocele, 

 and a more or less milky, pus-like fluid withdrawn. The scrotum eventually became 

 -extremely painful, and the swelling increased until it had attained almost to the size of 

 his head. He was admitted into the Greneral Hospital (for thickening and enlargement 



* I cannot avoid availing myself of the opportunity which this case also afiEords of reiterating the fact — for I 

 feel that it cannot be done too strongly nor too often — that the detection of Filariae, whether it be in the urine or 

 in the blood, is sometimes a matter of very considerable difficiilty. Hours may have to be spent in examining the 

 sediment of apparently excellent samples of Chylous urine before they are found ; fresh supplies may even be 

 required, for the numbers present may vary very much in different samples obtained from the same individual, 

 and, as may be learnt from some of the cases narrated above, they may be even absent for a time from either the 

 urine or the blood, or from both — at all events their detection required more patience than I was able to 

 command at the time of examination, whereas they were obtained with tolerable ease from the same persons on 

 subsequent occasions : I have also observed that, occasionally, they will disappear altogether for some time 

 previous to the disappearance of the Chylous condition of the urine. It will therefore be evident that no great 

 amount of foresight is required to be able to predict that, owing to want of proper appliances, want of time, 

 or other circumstances, such remarks as " Filariae were searched for but not found " will, not infrequently, be 

 recorded in connection with reports of Chyluria cases. 



