i6io 



THE FILARIASES 



same patient may have at times attacks of chyluria and haemato-^ 

 chyluria, and at other times attacks of lymphuria and haemato- 

 lymphuria. 



Treatment.— The treatment is purely symptomatic, and consists 

 of rest in bed, lying as much as possible in the prone position, while 

 in some cases methylene blue may be given in 2-grain doses, together 

 with salol, 5 grains, or urotropine in 5-grain cachets. The diet must 

 be bland, non-irritating. Astringent injections into the bladder have 

 been used, and gallic acid, nitrate of silver, acetate of lead, iodide 

 of potassium, and thymol have been administered internally, but 

 have not been found to be efficacious. Indeed, there is no justifica- 

 tion for their use. Administration of quinine, combined with 

 exposure to X rays, has been recommended bv Musgrave and 

 McDill. 



If the urine clots in the bladder, it must be washed out under 

 chloroform by means of an aspirator, and if this is not successful, 

 the bladder may have to be opened and drained. 



Chylous and Lymph Diarrhoea. 



Diarrhoea with chyle or lymph and blood in the motions has been 

 recorded, but is rare. 



Chylocele or Lymphocele. 



This may develop gradually, the tunica vaginalis filling up with 

 an opaque fluid, which on tapping is found to be chylous, and may 

 contain Micr 0 filar ub. It may, however, be preceded by an attack 

 of fever and orchitis. It is said that the sac is less tense in the 

 morning, and more so at night. 



Treatment. — -A chylocele does not grow to any large size, and 

 only requires occasional tapping. 



Chylous Ascites. 



Chylous ascites is rarely met with in human beings, though we 

 have seen two cases. It is common in animals as the result of 

 filarial infection. 



ELEPHANTIASIS. 



Synonyms.— Elephant Leg, Cochin Leg, Barbados Leg, Galle 

 Leg, Glandular Disease of Barbados, Elephantiasis Arabum, 

 Da-Fil, Dau-ool-Fil, Pes Febricitans, Perical, Phlegmasia Mala- 

 barica. Elephantiasis Indica, Bucnemia Tropica, Morbus Elephas, 

 Spargosis Fibroareolaris, Pachydermia, Hernia Carnosa, Elephan- 

 tiasis Tuberosa et Scrotalis, Hypersarcosis, Mai de Cayenne, Sarco- 

 cele d'Egypte, Roosbeen von Surinam, Shlipada, Kosharriddki, 

 Barawa (Sinhalese) . 



Definition. — Elephantiasis is a chronic inflammatory hypertrophy 

 of the fibrous connective tissue of a region of the body induced by 

 lymph stasis, arid resulting in a considerable hypertrophy of the 

 skin and subcutaneous tissues. 



