1966 DISEASES OF THE LYMPHATIC SYSTEM 



may be noticed. In due course a tumour is discovered in the sub- 

 occipital region, the elbow, axilla, side of the chest, iliac region, 

 gluteal region, or popliteal space. These tumours vary in size from 

 a pea to that of an egg, and lie in the skin or subcutaneous tissue, 

 in which they are freely movable. They may be elastic if they 

 contain fluid, or firm if composed mainly of fibrous tissue. They 

 usually remain quiescent for years, and but seldom ulcerate. 



Bernard and Ouzilleau believe that Onchocerca volvulus ma.y also give rise 

 ■to true elephantiasis in certain parts of Africa. 



Diagnosis. — The presence of an elastic tumour somewhat re- 

 sembling a lipoma, or of a firm fibrous tumour in any part of the 

 body of a person who has resided in the endemic region, should 

 arouse suspicions as to the presence of Onchocerca volvulus. 



When the nodules are in the proximity of articulations the condi- 

 tion may closely resemble the 'juxt a- articular nodules ' (seep. 2260). 

 The microscopical examination of the contents of the nodules 

 obtained by tapping with a syringe or by excision will clear the 

 diagnosis. 



Prognosis. — These little tumours are not in any way dangerous 

 to the life or health of the patient. 



Tr3atment. — Removal by incision and enucleation is quite easy, 

 and devoid of danger. 



Prophylaxis. — As the life-cycle of the parasite is unknown, 

 nothing can be said as to prophylaxis. 



REFERENCES. 



Climatic Bubo. 



Cantlie, James (1897). Lancet, January 2, 



Castellani and Low (1903). Journal of Tropical Medicine, December 15. 

 DuERCK (1903). Anatomischen Veranderung in der Bubonic Pest. Wien. 

 Ferraro (1903). Ann. Med. Naval. 



Fleischner (1909). Archiv fiir Schiffs- u. Tropen-Hygiene. 

 Gabbi (1909). Transactions of the International Medical Congress, Budapest. 

 GoDiNG (1896-97). British Medical Journal, September 26, 1896; and June 12, 

 1897. 



LuzzATTi, A. (1906). Ann. Med. Naval., p. 585. 



Manson (1918). Tropical Dieases. London. 



RosT, G. (191 2). Archiv fiir Schiffs- u. Tropen-Hygiene. 



RuGE, R. (1896). Archiv fur Dermatol, u. Syph., No. 3. 



Sergent and Raynaud (1918). Bull. Soc. Path. Exot., vol. xi., No. 3. 



Skinner (1897). British Medical Journal, January 9, p. 78. 



ZuR, Werth (1903). Archiv fiir Schiffs- u. Tropen-Hygiene, No, i. 



Volvulosis. 



Brumpt (1904). Revue de M^decine et Hygidne Trop. 



FiiLLEBORN (1908). Beiheft 7, Archiv fiir Schiffs- u. Tropen-Hygiene, vol. xii. 

 Labadie-Legrave et Deguy (1899). Archiv. de Parasitologie, p. 451. 

 Manson (1893). Davidson's Hygiene and Diseases of Warm Climates, p. 963. 

 Prout (1901). British Medical Journal, i. 209. 

 Vedy {1907). Archiv fiir Schiffs- u. Tropen-Hygiene, p. 565. 



