CHAPTER LXXXVIII 



DISEASES OF CONNECTIVE TISSUES, 

 MUSCLES, BONES AND JOINTS 



General remarks — Somatic taeniasis — Subcutaneous filariases — Dracontiasis — 

 Dermo-conjunctival filariasis — Loiasis — Calabar swellings — Dubini's 

 filariasis — Myositis purulenta tropica — Goundou — Boomerang bones — 

 Pes gigas — Endemic enlargement of the os calcis — References. 



GENERAL REMARKS. 



The diseases of the connective tissues which concern us are mostly 

 parasitic, being caused by the cysticerci of tapeworms, but round 

 worms are also commonly met with, especially the guinea-worm. 



With regard to muscles, a disease which must be mentioned is 

 trichiniasis , which is said to be far from rare in Northern India. 

 Necrosis, caries, and tumours of bone are not uncommon, but 

 rheumatoid arthritis is rare, and tubercular disease, at present, is 

 very rare. Gonorrhceal and post-dysenteric arthritis are met with, 

 and filarial synovitis of the knee-joint has een described by 

 Maitland. Gout is rare, but we have seen a typical case in a native 

 who had never left Ceylon. 



A peculiar condition called 'trench foot' has been met with in war zones 

 in the winter, and is therefore not a tropical disease. It is a painful con- 

 gestion of the foot, sometimes leading to gangrene, and associated with the 

 presence of spirochaetes and other organisms in the bullae (see p. 2149). 



DISEASES OF CONNECTIVE TISSUES. 



SOMATIC T^NIASIS. 



By somatic taeniasis is meant the invasion of the body by the 

 cysticercus of cestode worms. The subject is, therefore, divisible 

 into — [a) Cysticercosis, or infection with the larvae of Tcsnia solium, 

 which occurs now and again in the connective tissue of muscles, 

 fasciae, and in the brain; {h) Echinococcosis, which is the infection 

 of the body with the hydatids of Echinococcus granulosus, and of 

 which we have only met with one example in the tropics, and even 

 then it was imported; but, judging by Begbie's observations,, 

 it would appear as though the disease was endemic in Ceylon; 

 (c) Sparganosis, which is the invasion of the body by Sparganum 

 mmsoni, S. haxteri, or S. proUfer, all of which have been sufficiently 

 described in Chapter XXV., p. 596. 



1967 



