550 Pathological Significance of Nematode Hcematozoa. [part iii. 



She informed me that four years previous to her visit to me in 1873, her urine had 

 suddenly become of a milky aspect, but that in the course of a month it regained its 

 normal appearance. Eighteen months subsequent to this the disease returned without 

 any premonitory symptoms being observed. It disappeared as before, but returned as 

 bad as ever. I pricked one of her fingers with a needle and distributed a drop of 

 the blood thus obtained over six slides, in two of which several active Hsematozoa were 

 detected. 



To Dr. McConnell I am again indebted for opportunities of observing several 

 cases of Chyluria. One was a native shopkeeper, who, two years previous to his visit 

 to me, had an attack of the disease, lasting for about six months. The morbid symptoms 

 ceased suddenly, and did not return for four months, but when they did so he was affected 

 for some three months or more. He was unmolested for the next seven months, at the 

 end of which period the disease returned. It will be noted that during two years this 

 person experienced three attacks of Chyluria, suffering from the disease for more than 

 nine months out of the twenty-four. 



A somewhat similar case, but rather more aggravated, was kindly sent to me by 

 Dr. Henry Cayley. The patient vv^as a young man, an East Indian, bom and brought 

 up at Madras, and suftering, when I saw him, from a sixth attack of Chylous urine. The 

 first came on in September 1871, after a residence of two years at Coconada. All the 

 attacks had lasted about two months each, so that from the first onset of the disease 

 until now he has suffered for about twelve out of thirty months. 



Hsematozoa were present in the blood of both these cases ; as many as two 

 dozen were counted in eight preparations from the finger of the case last cited. The 

 urine also contained the parasite. 



I do not remember to have met with a patient suffering from an undoubted first 

 attack of the disease until August of the present year — a case which is also of 

 interest owing to the fact that the patient had never slept out of Calcutta, and 

 had not travelled more than about 20 miles beyond it. The man, who had been 

 referred to me by Dr. McConnell, was an East Indian, age 2*^^ a printer. A month 

 previous to the interview he had observed his urine to present a slightly milky 

 aspect, on the second day the milkiness increased, and on the third a slight 

 trace of blood was evident. The only premonitory symptoms had been " a dull, 

 aching pain " over the lumbar vertebrae, which, however, was not so severe as to keep 

 him from work. The pain had lasted for about three days before the urine became 

 affected, and it seems to have passed off when the milkiness appeared. There was no 

 previous history of the disease in the family, but his mother had suffered from haema- 

 turia two years ago. 



The blood was examined and found to contain numerous examples of the Filarice. 

 I did not examine the urine, but Dr. McConnell informs me that he did so and 

 found that Filarice were present in it. 



The four foregoing cases may be looked upon as fair examples of the disease 



