CHAPTER LXXXVII 

 DISEASES OF THE LYMPHATIC SYSTEM 



General remarks — Climatic bubo — Volvulosis — References. 



GENERAL REMARKS. 



The lymphatic system is affected in many general diseases — as, for 

 example, in plague and trypanosomiasis — and in cosmopolitan affec- 

 tions like septic disease, syphilis, tuberculosis, etc. In addition, 

 there is the enlargement of the glands in the inguinal region called 

 ' climatic bubo,' and the various pathological phenomena caused 

 by Filaria hancvofti. These morbid changes are varices of lymph- 

 channels, inflammations, and elephantiasis, and have already been 

 discussed in the chapter on Filariasis. The pathological changes 

 caused by Onchocerca volvulus must be mentioned here. 



With regard to the serous membranes, pleurisy and empyema are 

 common, while peritonitis from the perforation of a typhoid ulcer 

 or the perforation of the bowel by an Ascaris, as has been recorded 

 by Ziemann in the Cameroons, or from the extension of some septic 

 area — e.g., a gonorrheal salpingitis — are all met with. Chylous 

 ascites is rare. 



CLIMATIC BUBO. 



Synonym. — Glandula idiopathica (Brooke). 



Definition. — Climatic bubo is the enlargement of the inguinal 

 glands associated with pain and fever, the cause of which is unknown. 



ffistory. — ^The history of this disease only dates back to 1896, 

 when Ruge reported several cases suffering from inguinal buboes, 

 in which the usual causes of such an adenitis were all absent, and 

 he was therefore inclined to consider the disease a separate entity 

 dependent probably on climatic influences. About the same time 

 Goding, independently of Ruge, published a series of observations 

 apparently of the same nature, while more recently cases have been 

 reported by many observers. 



The disease has been recently investigated by many observers — 

 e.g., Riiffer, Luzzatti, Vanzetti, Rost, Nattan-Larrier, LetuUe, Ley, 

 and others. 



Climatology. — The chief geographical distribution of climatic 

 bubo is the East Coast of Africa, the West Indies, the Straits 

 Settlements, and China, but it may be met with in any tropical 



1961 



