FILAIUASIS AND ELEPHANTIASIS. 297 



fig. 2.) was lost sight of in the folds of the scrotum, the urine reaching 

 the surface along a channel formed hy skin. 



Fluctuation could be distinguished in a large proportion of these 

 cases, but frequently the thickening of the subcutaneous tissues was so 

 extreme that the fluid could not be reached with an ordinary needle. 

 This fluid, when obtained, may be milky or more commonly of a clear, 

 straw color. In our cases the amount obtained was about 350 to 500 

 cubic centimeters and was highly albuminous. Filarial embryos were 

 usually found in great numbers in this fluid. 



Glands of the groin. — Although some enlargement of the glands of the 

 groin was present in nearly every instance, but three cases were observed, 

 answering the classical description of varicose groin glands. The patients 

 were all men, 40 to 50 years old, and in each case other manifestations 

 of filarial disease coexisted. The glands involved were the superficial 

 inguinal, lying above and parallel to Poupart's ligament, and the disease 

 was bilateral in all of the cases observed. The swelling was larger than 

 that of the ordinary bubo, and was hard, without fluctuation, and could 

 be felt to be separated into a small number of detachable masses. It 

 was painless and not tender to the touch. The subjacent skin was freely 

 movable over the mass, which, however, was firmly fixed to the deeper 

 tissues. Attempts were made to obtain fluid from these glandular masses 

 with a hypodermic needle, but with the exception of a little blood and 

 serum nothing could be withdrawn. No history of an acute inflammation 

 in these glands could be obtained from any of the patients, except that 

 during the attacks of lymphangitis in the legs, they were tender. 



in. FILARIASIS. 



Examination of the blood of these patients showed the presence of 

 filarial embryos in but three instances. However, it was possible to 

 make examinations extending over the twenty-four hours of the day in 

 only seven of the number. In the other twenty-seven only specimens 

 taken during the daytime could be obtained. Two specimens out of the 

 seven examined, both day and night, had filarial embryos in their blood, 

 while of the twenty-seven whose blood was examined only during the 

 clay, one showed the parasite. 



A number of examinations were made upon the general population. 

 Of a total of eighty persons examined, filarial parasites were found in 

 the blood of eleven; out of thirty-seven prisoners in the provincial jail 

 at Albay, nine showed the presence of filarial embryos in blood specimens 

 taken at 10 o'clock at night. These were all short-term prisoners from 

 different towns in the Province of Albay. Out of 93 members of the 

 Thirty-second Company, Philippine Scouts, recruited from Bicol Prov- 

 inces, blood specimens from whom were sent to us by Dr. Warriner, 

 United States Army, nine, or 9.6 per cent were found to be infected. 



