i6o8 



THE FILARIASES 



seen in the axilla, groins, and other regions, which on superficial 

 examination might be taken for enlarged glands, but on palpation 

 it can be ascertained that they are composed of veins, the same 

 sensation being obtained as that experienced when palpating a 

 varicocele. When these masses occur in the groins they disappear 

 when the patient lies down. 



VARICOSE LYMPHATIC GLANDS. 



Synonyms. — Helminthoma elastica, Adenotymphoceles. 



Definition. — ^Varicose lymphatic glands are glands enlarged, some- 

 times to an enormous extent, by dilatation of their tymph paths, 

 brought about by obstruction to the flow of lymph. 



Remarks. — The glands most commonly found enlarged in patients 

 are the groin glands, less frequently those of the axilLne, while even 

 the parotid lymphatic gland has been recorded to have been 

 affected. In post-mortems, as already noted, the lumbar glands 

 may be found converted into septated sacs. 



Symptomatology. — ^The glands enlarge after attacks of fever, and 

 are usually found as soft, elastic swellings, which are easily movable 

 when small, and are covered with normal skin. They are found 

 in the groin, inguinal or femoral regions, and in the axilla. If 

 punctured with a hypodermic needle, lymph or chyle can be 

 obtained at times containing Micro filar ice. Usually small, they 

 may assume enormous proportions, reaching below the knee, and 

 seriously impeding locomotion. 



Treatment.— They may be removed if necessary, but this should 

 not be done without due cause, as they are only part of a more 

 widespread disorder. Radium treatment has been advised by- 

 Sir Havelock Charles. 



FILARIAL LYMPH AND CHYLOUS EXTRAVASATIONS. 



Lymph and chylous extravasations are due to the rupture of 

 dilated lymph or lacteal vessels into the urinary passages, the bowel, 

 the tunica vaginalis, or peritoneum. 



They may, therefore, be considered under the headings of 

 Cliyluria and Lymphuria, Chylous and Lymphatic Diarrhoea, 

 Chylocele, and Chylous Ascites. Perhaps further investigations 

 will show that Wise and Low are correct, and that in addition to 

 haemato-chyluria and other chylous conditions there may also be a 

 pure hgemato-lymphuria, lymphatic diarrhoea, lymphocele, and 

 lymphatic ascites. 



Chyluria and Lymphuria. 



Definition. — Chyluria is the passage of chyle with the urine, and 

 is due to the rupture of dilated chyle-containing lymphatic vessels; 

 when mixed with blood it is known as haemato-chyluria. When 

 lymph only is passed the term lymphuria, suggested b}^ Low, should 

 be adopted, and if mixed with blood, haemato-lymphuria. 



