1964 



DISEASES OF THE LYMPHATIC SYSTEM 



Climatic bubo is generally easily distinguishable from attacks of 

 filarial lymphadenitis, which is generally accompanied by very high 

 fever and severe lymphangitis, and an erysipelatous-like condition 

 of the leg. During and after various intestinal infections — as, for 

 instance, typhoid and paratyphoid — occasionally a suppurative 

 inflammation of some lymphatic glands — sometimes the inguinal 

 glands — occurs. In such cases the history of the case — the fact that 

 the bubo comes, as a rule, to suppuration — and the bacteriological 

 examination of the gland- juice, which in true climatic bubo is 

 sterile, will clear the diagnosis. 



Prognosis. — The prognosis is favourable, though in some cases 

 the affection may- last for several months. A relapse may occa- 

 sionally occur shortly after the first attack is over, sometimes 

 on the side previously affected, sometimes on the other side. 



Treatment. — The treatment is merely symptomatic, consisting of 

 complete rest, application of lead lotion on the affected region, or 

 an ichthyol and belladonna ointment, together with the administra- 

 tion of a mild aperient, and, if there is much pain, a hot fomenta- 

 tion locally, together with small doses of opium by the mouth. In 

 the rare cases, where signs of suppuration are noticeable, incision 

 of the glands is necessary, using the ordinary aseptic precautioDS. 

 In protracted cases complete surgical removal is the best treatment. 

 When the glands remain enlarged after the acute stage has passed 

 off, local applications of tincture of iodine, iodine valsol, or an 

 ointment composed of 30 grains each of lead iodide and potassium 

 iodide to i ounce of vaseline may be of benefit. X-ray treatment 

 has been recommended by G. Rost. 



VOLVULOSIS. 



Definition. — Volvulosis is a disease caused by Onchocerca volvulus 

 Leuckart, 1893, and characterized by the formation of fibrous, 

 cutaneous, or subcutaneous tumours. 



History. — As already mentioned on p. 649, these tumours were 

 discovered by a German medical missionary to contain worms, 

 which were described by Leuckart in 1893, and subsequently the 

 disease and its causative worm were studied by Labadie-Lagrave 

 and Deguy in 1899, Prout in 1901, Brumpt in 1904, Ziemann and 

 Vedy in 1907, and Fiilleborn in 1908, the last paper being a most 

 valuable contribution to our knowledge of the ^.ubject. 



Climatology. — The disease is found in Africa, at Sierra Leone, 

 on the Gold Coast, and in Dahomey, Cameroons, and the north- 

 east of the Congo, where it is variously stated to affect from i per 

 cent, to 10 per cent, of the population, being distributed along the 

 banks of rivers. Brumpt found it along the Welle, Cooke in Uganda, 

 and Parsons in Northern Nigeria. 



etiology. — The disease is caused by Onchocerca volvulus Leuckart, 

 1893, but the method by which this worm is introduced into the 

 human body is quite unknown, as is also its life-cycle outside 



