REFERENCES 



1979 



tarsal bones are hypertrophied, and the second and third united, 

 while the terminations of the toes are club-like. In Cousland's 

 case there was marked hypertrophy of the calf muscles. 

 Treatment. — It has not been treated so far as we know. 



ENDEMIC ENLARGEMENT OF THE OS CALCIS. 



Definition. — Endemic enlargement of the os calcis is a disease of 

 unknown causation, characterized by fever, pain, and tenderness 

 over, and subsequently enlargement of, the os calcis. 



History and Climatology. — This disease was first described by 

 MacLean in 1904 in Fantis and Krooboys in the Gold Coast Colony, 

 and subsequently in 1905 by Maxwell in natives of Formosa. 



etiology. — The aetiology and pathology are obscure, but in < 

 some way it is connected with the wet season, as attacks and 

 recurrences take place then. 



Symptomatology. — The disease begins suddenly with fever, 

 great tenderness over the os calcis, with local pains so severe ar to 

 prevent sleeping and walking. In three to seven days the outer 

 surface of the bone begins to increase in size, and continues to do 

 so for some two weeks, during which time the pain lessens and the 

 temperature falls to normal. 



In about a month the swelling reaches its maximum size, at 

 which it may remain for about one to two months, during which 

 time the pain is moderate and walking is possible. After this the 

 bone diminishes to about half the maximum size, but sometimes 

 considerable enlargement persists. Usually the disease is bilaterally 

 symmetrical, but it may occur on one side only. It affects the 

 outer surface as a rule, but may also attack the posterior third of the 

 bone. 



Rarely it attacks other tarsal bones, but has never been reported 

 as affecting a joint. Yearly recurrences during the wet season are 

 common. 



Treatment.— Medical treatment is useless, but relief is given by 

 cutting down on to the affected area and trephining a hole into the 

 bone. 



Prophylaxis. — Concerning this nothing is known. 



REFERENCES. 



Somatic Taeniasis. 



Castellani (191 8). Ann, Med. Navale. 

 Chalmers (1904). Spolia Zeylanica. 



Stiles (1906). Bull. No. 25, Hyg. Lab. U.S. Pub. Health and Mar. Hosp . 

 Service, Washington, 1906. 



Draco ntiasis. 



Dudgeon and Child (1903). Journal of Tropical Medicine, 1903. 

 Mackenzie (1898). Journal of Tropical Medicine, i. 113. 

 Remlinger (1904). Comptes Rendus de Soc. de Biolog., Ivii. 76. Paris. 

 TuRKHUD (1914). Report of the Bombay Bacteriological Laboratory for 

 1 91 3, p. 15 (Turkhud's experiments on man). Bombay. 



