CHAPTER LXVI 



THE FILARIASES 



Synonyms — Definition — Filariasis caused by Filaria bancrofti Cobbold, 1877 — 

 History — Climatology — etiology — -Pathology — Clinical description — 

 Filarial lymphangitis — Filarial orchitis and hydrocele— Lymphatic 

 varix — Varicose lymphatic glands — Chylous effusions — Elephantiasis — 

 Rarer affections — Filariasis caused by other Filaridae — References. 



Synonyms. — Filarial disease. French, Filariose, Maladies filariennes ; 

 Italian, Filariasi; German, Filaria Krankheit. 



Definition. — Filariasis is a term denoting the infection of man 

 or animals by any species of Filaria — e.g., Filaria hancrofti Cobbold, 

 1877, and some others. 



FILARIASIS CAUSED BY FILARIA BANCROFTI Cobbold, 1877. 



The diseases produced in man by Filaria hancrofti Cobbold, 1877, 

 include lymphangitis, orchitis, varix in lymphatics and lymphatic 

 glands, chjdous and lymphatic extravasations, and elephantiasis. 



History. — -The appearance of the huge leg of elephantiasis is so striking 

 that it was early noticed by ancient Indian writers, who give descriptions of 

 diseases which clearly refer to elephantiasis of the leg and of the scrotum, 

 and also less clearly to lymph scrotum. Further, they appear to have known 

 that elephantiasis could affect the hands and other parts of the body. 



The word ' elephantiasis ' was first used by Celsus to indicate leprosy, 

 and in this he was followed by most writers until Galen, who included true 

 elephantiasis under the sam.e term, an error which became firmly established 

 as time passed. In the ninth and tenth centuries Rhazes and Avicenna, 

 and other Arabian physicians, described true elephantiasis of the leg under 

 the term ' da-fil ' or ' dau-ool-fil,' or elephantine disease, which, however, 

 only served to make the confusion between the two diseases more com- 

 plete. In the seventeenth century Leonicenus and Varandaeus pointed out 

 that they were two distinct clinical entities, and in 1709 Clarke described 

 elephantiasis on the Malabar coast of India under the term ' Cochin leg.' 

 In 1 712 Kaempfer described endemic hydrocele, under the term ' andrum,' 

 as occurring in India, and being associated with erysipelatous eruptions 

 on the scrotum, which recurred at the time of the new moon. He also de- 

 scribed a large foot under the term ' perical,' but his description agrees more 

 with Madura-foot than with elephantiasis, though it is probable that he was 

 confusing both diseases under the same term. In 1750 Hillary, a most 

 careful and skilled observer, gave the first full and accurate account of the 

 evolution of the large leg of elephantiasis, which he clearly differentiates 

 from true leprosy, describing the successive attacks of fever, the lymphangitis 

 and lymphadenitis, and the swelling of the hmb, which, gradually becoming 

 permanent and slowly increasing, produces the well-known condition. 



He was ably supported in 1784 by Hendy, who, in a subsequent treatise 



1595 



