DROPSY. 391 
Where ascites exists other significant symptoms are present; and some are 
attributable to disturbances of the internal organs induced by pressure. The 
appetite is impaired; vomiting occurs occasionally; the coat is harsh and 
rough ; respiration is embarrassed if the effusion be considerable; the urine is 
scanty ; and in a large proportion of cases constipation alternates with diarrhcea. 
When the quantity of fluid is large, circulation in the legs is obstructed, and in 
consequence they also become dropsical. 
It is not long after dropsy forms before emaciation becomes quite evident ; 
the lips, tongue and gums grow pallid; the pulse, at first rapid and feeble, is 
eventually thin and thready; the breathing is more hurried; finally the poor 
sufferer can no longer lie down, and death soon results from exhaustion, or 
perhaps suffocation. 
Thus far this discussion has been confined to abdominal dropsy when it 
occurs as a symptom of organic or constitutional disease. Now will be con- 
sidered a form of dropsy that is caused by the parasite flarza zmmttzs. 
The embryos of this are scattered through the blood, while the matured 
generally inhabit the right side of the heart and large vessels, as the aorta 
and pulmonary artery ; and cases are on record in which the heart and lungs 
were pierced by these worms. In one instance a nest of them was found in 
the left lung as large as a native walnut; while in several others the liver and 
spleen were studded around their edges with blackish lumps, interspersed with 
occasional white ones, all about the size of peas, and filled with what seemed 
to be embryos of this parasite. 
The lungs of the victims generally present a peculiar ashen color; while 
their livers are dark, and the substance of them is thickened and hardened. 
Changes quite characteristic are usually noted in the heart. It is enlarged, 
and its cavities are distended; its lining membrane is inflamed or exhibits 
traces of previous inflammation; large dark red clots are found on its right 
side, in which there are usually well developed filaria, varying in number from 
three or four up to fifty. 
The kidneys also present serious abnormalities, usually in the form of 
chronic inflammation of the lining membrane; while here and there in vari- 
ous cavities are discovered embryos of the parasite. 
Plugging of arteries by clots, especially those of the lungs, is another 
frequent condition ; while the veins, particularly of the posterior extremities, ex- 
hibit signs indicating that circulation through them is more or less obstructed. 
Dropsy eventually manifests itself; and the effusion, which is a thin amber- 
colored fluid, takes place into the pleural and abdominal cavities. Rarely, 
however, is the quantity large at first; indeed as a rule it accumulates only 
slowly ; and may not become excessive for even a year or more. 
As for the number of filaria which may be in the blood of a victim, in one 
case it was estimated to be not less than a million. 
