Filaria loa 47 



That the swelling is caused by this parasite seems not to be a 

 fact absolutely established. However, upon one occasion within 

 the knowledge of Mr. K., one of these upon the dorsal surface 

 of a woman's hand, being rubbed with a view to removing it, the 

 parasite was seen to emerge from the tumefaction and make its 

 way across the metacarpo-phalangeal articulation, from which 

 location it was extracted. Upon another occasion the swelling 

 appeared, upon his own person, over the right frontal eminence. 

 Within an hour it had extended downwards across the supra- 

 orbital arch, along the right side of the nose, and outward be- 

 neath the eye as far as the outer limit of the orbit. During this 

 process, when the swelling reached the side of the nose, the 

 movements of the parasite became visible beneath the skin and 

 upon the surface of the tumefaction, where it was seen to cross 

 below the eye, and the sharp, stinging sensation was apparent to 

 its host as it made its way downward across his cheek. From 

 these and similar observations there would appear to be little 

 room to question the correctness of the assumption that the oc- 

 currence of this swelling is conclusive evidence of the presence 

 of the parasite. 



The swelling is from three to five or eight centimeters in diam- 

 eter and not greatly elevated. The appearance of its cutaneous 

 covering remains normal. A sharp stinging or smarting sensa- 

 tion with more or less itching attracts attention where the swell- 

 ing is about to appear. The swelling is indurated and is some- 

 times accompanied by great pain, but in other cases pain is 

 absent. From its first appearance until the part returns to its 

 normal condition a period of two or three days elapses. It occurs 

 upon the head or face, the wrists, hands or fingers, the ankles, 

 feet or toes. It is seldom seen upon other parts of the body. 

 This may be accounted for by the relative deficiency of subcu- 

 taneous connective tissue in the parts mentioned. When the 

 joints of the extremities are involved, marked stififness and pain 

 are felt on motion, and in some instances creaking of the joint 

 so marked as to sometimes be audible at a distance. No distinc- 

 tion of age, sex, or condition exists as to susceptibility to inva- 

 sion of this parasite. The host is never aware of its presence 



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