FILARIAL DISEASES 305 



the body may occasionally become enlarged. In some South 

 Sea Islands 50 per cent or more of the population are thus affected. 

 The disease begins by repeated attacks, at intervals of from a 

 month to a year, of " elephantoid " or filarial fever in which 

 chills and high fever accompany a painful swelling of the parts 

 affected. These attacks, also known as lymphangitis, end in an 

 emission of lymph and a partial subsidence of the swelling. 

 But each attack leaves a little more permanent tissue, so that in 

 time the growth, which is hard and unyielding, develops to enor- 

 mous proportions. Sometimes an affected leg may reach a diam- 

 eter of several feet. In one case recorded by Manson, a scrotum 

 affected by elephantiasis reached a weight of 224 pounds, though 

 it must be admitted that this is unusual. 



Another condition resulting from filarial infection is the escape 

 of the contents of lymph vessels into the kidneys or bladder, a 

 condition technically known as " chyluria." The urine is milky 

 and coagulates after standing a short time. This condition lasts 

 for a few days or weeks, then ceases and returns at irregular 

 intervals. It produces severe anemia and a general * feeling of 

 ennui, and saps the vitality. 



Occasionally the presence of dead filarise in the body leads to 

 the formation of abscesses which sooner or later discharge. If 

 on any of the appendages, no further trouble results, but such 

 abscesses in the internal regions of the body may have serious or 

 fatal effects. 



Though very probably some of these so-called " filarial dis- 

 eases " are caused directly by the filarise, the exact relation of 

 F. bancrofti to all of the pathological conditions associated with 

 its presence in the body is far from settled. Butcher and Whit- 

 marsh, of the United States Army, in investigations of filarial 

 diseases in Porto Rico recently obtained pure cultures of a certain 

 type of bacterium from the blood or serum of 15 patients, all 

 but one of whom was affected by some form of filarial disease, 

 whereas in unaffected individuals, with one exception which was 

 looked upon as a " carrier," the cultures from the blood remained 

 uniformly sterile. In a few cases in which filarial diseases were 

 present the bacterium was not found but it was believed that 

 either the infection was so light that the cultures did not happen 

 to become contaminated, or that the infection had died out. 

 A number of other observers have obtained cultures of bacteria 



