1888-89.] Dr R. W. Felkin on Tropical Diseases. 
305 
it is more frequently seen. It is said to be often found to the 
west of Lake Nyassa. In the western hemisphere elephantiasis 
is met with in New Granada, Venezuela, and Peru, in those parts 
of Brazil which are mostly tropical in character, on the coasts 
and marshy levels of Guiana, on the Gulf coast of Central America 
and of Mexico. Elephantiasis is also seen in the following islands 
of the West Indies: — Barbadoes, Martinique, Guadaloupe, Trinidad, 
St Vincent, and St Bartholomew. 
Remarks . — Although sporadic cases of elephantiasis are met 
with occasionally in Turkey, the south of France, Lisbon, and the 
south of Spain, as well as on the east coast of Scotland and in some 
parts of the south of Ireland, the endemic area of elephantiasis is 
from 35° 1ST. to 25° S. in the eastern hemisphere, and 25° jST. to 
30° S. in the western. We must, therefore, consider that the 
disease for the most part depends upon high temperature and much 
atmospheric moisture for its production. Where cases occur 
outside the limits indicated above, it is in connection with moist 
soil and humid atmosphere, such as is met with on sea coasts and the 
banks of rivers. Climate not only appears to influence its pro- 
duction, but variations in temperature undoubtedly bear some 
relation to its growth, and some observers have maintained that it 
has a lunar periodicity. At any rate, as Hirsch says, “ the more flat 
and damp the ground is in a tropical or sub-tropical piece of country, 
the more suited does it seem to be for the endemic existence of 
elephantiasis.” Various theories have been advanced to explain the 
production of this disease. It has been said to be due to fish 
forming the staple of diet, to the drinking of water rich in saline 
constituents or tainted by organic matters ; and others have thought 
that it is a form of malarial poisoning, but there are numerous facts 
which prevent these views from obtaining general assent. It is, 
however, agreed by nearly all observers that the disease attacks 
principally the male sex, of dark races, over twenty years of age. 
Before concluding this note, it may be remarked that there is an 
increasing number of observers who believe that the cause of 
elephantiasis is the filaria sanguinis hominis • the maps show how 
far the distribution of this parasite is identical with that of 
elephantiasis. 
vol. xvi. 12/8/89 
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