FILARIASIS AND ELEPHANTIASIS. 301 



cord tied around the leg to prevent the swelling advancing higher. 

 (Plate I, fig. 2.) However, quite as futile as the string have been the 

 numerous parasiticidal drugs that have been used from time to time for 

 the treatment of filariasis: thymol, quinine, boric and benzoic acid, 

 sodium benzoate, and numerous others. Scheube records a cure with 

 picric-nitrate of potassium, and reports another by Flint, who used 

 methylene blue for the purpose. 



Eest, elevation of the parts, and compression by means of bandages 

 are the means most frequently employed for the treatment of elephan- 

 tiasis of the extremities. Hot baths and local applications of mercurial 

 ointment are also used with benefit. Surgical measures, such as excision 

 of longitudinal strips of skin, and the ligation and compression of the 

 arteries supplying the part have been proposed, but are of no value and 

 are dangerous as well. The combination of rest, elevation and compres- 

 sion together with injections of thiosinamin has been quite successfully 

 employed by Castellani in Colombo, who, in 1907, reported the result 

 of such treatment on a number of cases. His method of treatment D is 

 to keep the patient in bed for a week, in the meantime bandaging the 

 affected part with flannel or rubber bandages, and using massage twice 

 daily. The thiosinamin solution is then injected into different parts of 

 the affected area, 2 cubic centimeters of the solution every day or every 

 other day. After the injections, the jDart is again tightly bandaged. A 

 month or more of this treatment usually suffices greatly to reduce the 

 affected parts, and the use of a puttee or elastic stocking will keep the 

 swelling down. This treatment is only palliative and the enlargement 

 will return if all compression is removed. The treatment of elephantoid 

 disease of the scrotum is largely surgical and will not be considered here. 



The prevention of such diseases is of great interest to us. The only 

 way to insure protection against filarial disease in an endemic locality 

 is by the methods of prophylaxis, based upon our knowledge of the life- 

 history of the parasite. The anti-mosquito measures taken to insure 

 protection from malaria will be equally efficient in warding off filarial 

 disease. In addition, the blood of native servants should be examined 

 after 10 o'clock at night for the presence of filarial embryos, and no 

 person harboring the parasite should be employed about the house. 

 Sporadic cases reported from widely separated sections indicate that 

 these precautions would not be out of place anywhere in the Islands. 

 In the military service it would be advisable to have not only the house 

 servants examined, but also all natives employed in any capacity about 

 the posts, and to prevent those infected from holding any position that 

 would bring them about the posts at night. The routine examination of 

 the blood of recruits for the Scout organizations would keep many men so 

 affected out of the service, thereby removing a source of infection to their 



6 77ws Journal (1908), 3, 311. 



