303 
1888 - 89 .] Dr R. W. Felkin on Tropical Diseases. 
are rarely attacked by it, and as yet there is no case on record of 
a European or half-breed suffering from it. 
Geographical Distribution . — Broadly speaking, this disease is 
met with in its dark variety in Madras, Bombay, the west and 
north-west of India, whilst cases of the pale variety occur all over 
India. The Malabar coast and inland places near it are chiefly 
affected, and the disease is reported as being present at Pondi- 
cherry, Bellary, Tanjore, Guntoor, Madura (whence one of its 
names), Cuddapah, Trichinopoly, and Combacumum. It is also 
met with on the slopes of the western Ghauts, in Rutnagherry, 
Poonah, and other parts of the Bombay Presidency, as well as 
in Kattivar, Goojerat, and Cutch ; in Kurrachee and other places in 
Scinde ; in Bawalpur, Bicanir, and other parts of Rajpootana ; and 
in the Punjaub at Jhelum, and the North-West Provinces at Sarsa 
and Hissar. It is very rare in Bengal, and the cases met with in 
Calcutta are all imported. 
Remarks . — It is most difficult to refer the cause of this disease 
to definite physical phenomena. It appears, however, that it is 
associated with certain definite local conditions, although what 
these conditions are it is hard to say. At the places where it occurs 
there is a heavy rainfall, the altitude of the district is not high, and 
as a rule the soil is moist, dolometic, and rich in vegetable matters. 
At the same time, it must be noticed that at Cuddapah the soil is 
clayey limestone, that at Pondicherry it is clay, and at Tanjore and in 
the places where the disease is known on the Malabar coast, the soil 
is alluvial. It is highly probable that the disease has an intimate 
relation to the soil; those most affected by it are persons employed 
in agriculture, and who go barefooted, exposing themselves thereby 
to wounds on the feet, which would readily permit the tissues to be 
invaded by a parasite, if a parasite, as we believe, causes the 
disease. 
XIII. Elephantiasis Arabum. 
(See Plate IX.) 
Synon . — Barbadoes Leg ; Cochin Leg ; Bucnemia indica ; Pachy- 
dermia ; Fr. Elephantiasis ; Ger. Elephantiasis. 
Definition . — A non-contagious disease, characterised by recurrence 
of febrile paroxysms, attended by inflammation and progressive 
