Filaria toa 41 



In the eyelid the Loa is apt to give rise to a slight tumefaction 

 at least, and this may simulate entirely different conditions. 

 Thus in the case recorded by Dr. Thompstone (No. 36) the 

 parasite lay in the lower lid at the inner canthus close to the 

 lachrymal sac, the swelling in that region giving the appearance 

 of dachryocystitis. When an effort was made to press out the 

 contents of the sac, the worm wTiggled away. 



F. loa may migrate from point to point under the skin without 

 producing any visible effect upon the parts invaded. Thus in 

 different cases it has been watched in its migrations from the 

 eye to the forehead, or over the bridge of the nose to the other 

 eye or under the skin of the back or chest; and in all of these 

 it is not recorded that any modification of the normal appearance 

 of the part followed the movements of the w^orm. One of the 

 most distinct and trustworthy of these observations is that quoted 

 from Starr in the present paper (p. 6). 



CALABAR SWELLINGS 



The first publications I have found on the nature of Calabar 

 swellings (the Kamerungeschwlilste of the German authors) are 

 in the book by Plehn (1898) and a contribution exclusively on 

 this topic by Thompstone (1899), ^ district medical officer in 

 Old Calabar. To be sure they were recognized as a distinct 

 disease much earlier, and are referred to under this name by 

 Robertson (1895). Since then numerous references have been 

 made to their occurrence, and several observers have discussed 

 at length their character and cause. They are apparently spon- 

 taneous and fugitive in character, appearing suddenly and 

 requiring two to three days to disappear. In size half that of a 

 goose egg, they may occur on any portion of the body, though 

 according to most they apparently favor the extremities. They 

 are painless and do not pit under pressure. According to Thomp- 

 stone they come one at a time and recur at irregular intervals 

 of time. He also states they are somewhat hot both objectively 

 and subjectively, wdiile Joseph (1903) states distinctly that they 

 are accompanied by no temperature. 



3" 



