i6o6 



THE FILARIASES 



discharge either lymph or chyle containing filarial embryos, or, much 

 more rarely, eggs. 



If the vesicles are ruptured, the discharge of lymph may be quite 

 considerable in the twenty-four hours, and may produce such 

 marked exhaustion in the patient as to necessitate an operation. 



In the spermatic cord the disease begins with pain and swelling 

 in the testicle, cord, and lower part of the abdomen, associated at 

 times with fever. When the acute symptoms have subsided, a 

 swelling like a varicocele, which disappears in the prone position 

 and reappears when standing erect, will be noticed along the cord, 

 but the vessels constituting the swelling will be noted to be softer, 

 less tortuous, and more like a series of pouches than a true varicocele. 



Fig, 715. — i'lLARiAL Lymphangiectasis. 



In lymphangitis of the leg there is the same fever, with swelling 

 of the glands, leaving a soft swelling in the groin, which disappears 

 on lying down and reappears on standing up, and which has no 

 impulse on coughing. 



Treatment. — As the local condition is simply part of a much more 

 generalized varicosity of the lymphatic vessels, it is best to treat it 

 symptomatically with antiseptic dusting-powders, such as boracic 

 acid, zinc oxide, and dermatol, etc. 



If, however, lymphorrhagia is taking place and the patient is 

 becoming exhausted, it is necessary to remove some of the diseased^ 

 tissue and to ligate the dilated vessels, but in so doing it is as well' 

 to warn the patient that this will not cure the disease, and, indeed, 

 may be followed by elephantiasis or even chyluria. 



FILARIAL ABSCESSES. 



Manson, Low, Wise, Bahr, and others, have called attention to 

 the frequency of filarial abscesses in various parts of the body. 

 The most important are those found in the thorax and in the retro- 

 peritoneal tissues. In the latter situation the symptoms may be 

 those of peritonitis. 



