THE FILARIASES 



gauze bags filled with ordinary small lead shot are found especially 

 useful. In some cases massage of the whole limb before bandaging 

 is useful. It is of the utmost importance that the pressure on the 

 whole limb should be well distributed, otherwise the parts on 

 which insuhicient pressure has been made will be found to become 

 swollen. It is also useful to keep the affected limb continually 

 elevated by means of pillows, etc. In cases of verrucose elephan- 

 tiasis in which the skin is covered with numerous horny masses, a 

 spirit lotion of resorcin and salicylic acid (ac. salicylici, resorcin, 

 aa gr. xxx. ; sp. rect., giv.) is useful in removing these horny masses. 



Fig. 721. — -The Same Case as in Fig. 720: After Treatment by Fibfo- 

 LYSiN AND Bandaging, and without any Operative Measures. 



In successful cases after three to six months of this treatment the 

 affected parts are of much smaller size, the skin is smoother, rtiore 

 elastic, and can be pinched into folds. Long elliptical strips of the 

 redundant skin and subcutaneous tissue may then be removed, the 

 margins of the wound being stitched together. This would not be 

 practicable before the medical treatment, as the skin being enor- 

 mously thickened and inelastic, the coaptation of the opposed sur- 

 faces could not be obtained. 



In our experience this treatment has generally only a slight and 

 temporary effect in recent cases when the disease is in the acute 

 stage with frequent attacks of filarial fever. On the other hand. 



