PA THOLOGY— SYMPTOM A TOLOGY 



1965 



human beings. Brumpt has, however, suggested that it will 

 probably be found in a tsetse-fly, because of its riverine distribution 

 and the fact that microfilariae have been found in the peripheral 

 circulation by Fiilleborn, Rodenwalt, and others. 



Pathology— The adult worms lie in lymphatics, the anterior end 

 of the female being in close approximation to the posterior end 

 of the male, because the apertures of the genital apparatus he m 

 these positions. By some means — possibly by the presence of the 

 Mic'ofilarid, or possibly by toxic waste-products — these worms 

 irritate the lymphatics, causing lymphangitis and perilymphangitis. 

 These inflammatory processes eventually lead to the formation of a 

 fibrous capsule around the worms, which then lie in a portion of a 

 vessel cut off (?) from the rest of the lymphatic system, and which 

 forms a fibrous subcutaneous nodule containing male and female 

 worms and Microfilarice. 



Fig. 788. — Tumour containing Onchocerca volvulus Leuckart, 

 (After Fulleborn.) 



On opening one of these tumours it is seen to consist of a capsule 

 of fibrous connective tissue, beneath which is some soft caseous 

 material composed of endothelial cells, granular debris, and Micro- 

 filaricB, and to enclose a central space containing a greenish, semi- 

 purulent fluid. The worms, which are usually cut across in several 

 places when opening the tumour, lie partly in this central cavity 

 and partly in narrow twisted tunnels, which ramify through the 

 walls of the fibrous capsule, giving it a network-like appearance. 

 Sometimes the central cavity is not obvious, and only the network 

 of tunnals is seen ramifying through the connective tissue. 



Symptomatology.— The disease, as a rule, begins insidiously with 

 malaise, weaknsss, vague pains in various regions of the body, and 

 irregular fever, but it is said that at times attacks of lymphangitis 



