Lymphangiedasis . Dilated Lymphatics. 551 



The causes of lymphangiectasis appear to be generally some ob- 

 struction to the onward flow of the lymph. Any diseased con- 

 dition, therefore, that causes compression of the larger lymph 

 vessels may cause dilatation of the smaller ones leading into these. 

 General distension may come from disease of the lungs or left 

 heart and increased venous blood pressure, or from thrombus of 

 the jugular, or a tumor obstructing the thoracic duct, while local 

 engorgments may come from the pressure of tumors, or the oc- 

 currence of lymphangitis and formation of fibrinous coagula. In 

 cases of partial obstruction of the lymph vessels, the increased 

 secretion of lymph may lead to distention and enlargement. It 

 may be named in this connection that irritation of the sensory 

 nerves in dogs has been shown to determine a larger production 

 of lymph (Krause). Lymphadenitis and the obstruction of the 

 passage of lymph through the glands is an obvious cause, and 

 hence the disease is specially liable to appear in connection with 

 diseases which show a predilection for the lymphatics (tuberculo- 

 sis, glanders, strangles, carcinoma, etc.). 



In his work on dilatation and occlusion of lymph channels, 

 Busey shows that in man the majority of cases are in hospital pa- 

 tients in whom blood and general health have been impoverished 

 and reduced by unhygenic conditions. One case gave support to 

 the theory of maternal impression, the pregnant mother having 

 suffered from over-use of the right limb on a sewing machine, 

 and the offspring having shown extensive lymphangiectasis in 

 the right leg. 



Symptoms consist in enlargement of the lymph vessels or 

 plexus, and often of the glands, If of the lymph plexus, it may 

 appear like a dropsical effusion in the part, with or without sac- 

 cular dilatations at intervals. If of the larger vessels, their tor- 

 tuous anastomosing trunks, following largely the lines of the veins, 

 are usually characteristic. If the distention is slight it is usually 

 moniliform, as the valves are still intact, and the intervals be- 

 tween them stand out as bladder-like masses. If the structure is 

 wounded or if it ulcerates there is the discharge of a straw-col- 

 ored fluid, often rendered milky by the presence of fatty granules, 

 and at times tinged with blood. • There is always a tendency to 

 the increase and condensation of the connective tissue surround- 

 ing the vessels, and fatty degeneration and the formation of lipo- 

 mata are not uncommon. 



