42 Henry B. Ward 



Robertson (1895) was apparently the first to call attention to 

 the fact that his patient, afflicted with F. loa, also suffered from 

 Calabar swellings. Later observations on the same patient (Rob- 

 ertson, 1897) record an immediate recurrence of the trouble on 

 return to Old Calabar, where itching behind the eyes and swell- 

 ings on the arms are almost universal among the natives. He 

 also says that when the parasites are felt moving, headache and 

 nausea as well as puffy swellings of the arms are troublesome, 

 while all parts of the body may be affected, especially the scalp. 



In regard to the cause of these swellings, Manson (1903) 

 sums up the case well when he says, "Their peculiar geographic 

 range, which it would seem includes the Congo basin, the fact 

 that they come and go, the fact that they persist in recurring 

 after the subject has left the endemic districts, render it prac- 

 tically certain that they are of parasitic origin." In the same 

 paper he reports a series of eight cases of the disease among 

 missionaries on the Upper Congo, two of which had been under 

 his personal care. He further notes the general association with 

 F. loa, and conjectures they may be due to the parturition of 

 this species. Their association with F. loa and possible relation 

 to that parasite had already been commented on by Robertson. 

 The absence of F. dinrna, the conjectured embryonic form of 

 F. loa, as shown apparently by his blood tests, may easily be due 

 to failure to make preparations at the proper time or place. 

 Furthermore, the geographic distribution of this malady is much 

 the same as that of F. loa, which would further strengthen the 

 view that there exists a causal relation between the two. 



More recent publications have brought forward additional 

 proof of this causal relation. Thus Habershon ( 1904) has pre- 

 sented strong evidence in favor of the view, when he reports 

 that almost every European at Yakusu suft'ers, and adds details 

 of several cases which were under careful continuous observa- 

 tion and showed the presence also of F. loa. In one case the 

 attack commenced with the most intense neuralgic pain, followed 

 by swelling of the part affected, which began a few hours later 

 and was comparable to an attack of acute myositis. Kerr ( 1904) 

 also adds evidence on the relation between F. loa and the Calabar 



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