FART III.] Association of Nematode Hcematozoa with Elephantoid States. 555 



vascular system generally are capable of withstanding; and when the extremely 

 intimate relation which the capillaries hold to the lymphatic spaces, so carefully 

 described by Dr. Klein,* and the excessive delicacy of the several partitions, are 

 borne in mind, it is not to be wondered at that the urine under such circum- 

 stances should contain sanguineous and chylous fluid — the latter seldom or never 

 without some trace of the former; and that extravasations of the same fluids should 

 take place in the scrotum and elsewhere. Possibly these leakages occur far more 

 frequently, and into more organs and tissues than at present imagined— the pro- 

 cesses of assimilation, of absorption, and of repair following the injury so quickly 

 and so completely as not to attract special attention to the part. 



The fact that these leakages are not limited to the urinary tract is of moment ' / 

 in considering the etiology and pathology of the disorder, inasmuch as it would have 

 been difficult to imagine that rupture and extravasations could only occur in renal 

 tissue or along the lining surfaces of the channels leading from it, for the capillaries 

 have no such limited circulation ; although, on the other hand, it might be argued that 

 the urinary tract may have been affected by some such parasite specially localised in 

 its own tissues just as the hepatic and pulmonary tissues have theirs ; but the young, 

 at all events, of this filaria have a far wider distribution than this. 



Whether the mature worms — the parents of the microscopic nematode haematozoa 

 in man — also take up their abode in the circulatory fluids, or merely deposit their ova 

 (or embryos if viviparous) in such situations as will eventually lead to their being 

 conveyed into the circulation, is of little moment, for the mischief which large-size 

 worms accomplish when merely lodged in the cavities of the heart and larger blood- 

 vessels, judging from what we know of the Filaria iTnmitis and other blood-worms, 

 would seem not to be invariably or even generally of so serious a nature as might 

 have been supposed. The injuries inflicted on the walls of the aorta of the dog by 

 the Filaria sanguinolenta, described on a previous page, are of a far more formidable 

 character, and, in all probability, eventually interfere more with the well-being of the 

 victim, than if the parasite had simply perforated the vessel and acquired maturity 

 whilst, possibly, attached to one of the " columnge " of the heart. 



It is difficult to embody in a few words, without risk of misinterpretation, the 

 substance of observations such as the foregoing on what is admitted to be an extremely 

 difficult subject; nevertheless, it might be desired that I should express briefly (1), 

 the chief reasons for the belief that Chyluria and the elephantoid state of the tissues, 

 referred to on a previous page, are associated with the presence of a microscopic 

 Hsematozoon ; and (2), in what manner, such connection being satisfactorily established, 

 this fact can aid us in ofi'ering an explanation of the evidence we possess that the »/' 

 disease is due to mechanical interruption to the flow of the nutritive fluid in the 

 capillaries and lymphatics : 



(1) — With regard to the first clause, it may be sufficient to state that detailed 

 , * The Anatomy of the Lymphatic System. 1 — The Serous Membranes. 



