19,3 Maxwell: Filar iasis in China 269 
I. Inflammatory mischief, either directly or indirectly connected with 
the parasite. 
1. Elephantoid fever. 
2. Lymphangitis. 
3. Erysipelatoid inflammation. 
4. Dermatitis and cellulitis. 
5. Abscess. 
6. Orchitis. 
7. Acute arthritis or synovitis. 
8. Gangrene of the scrotum. 
9. Filarial haemoptysis. 
II. Disease due to obstructive interference with the lymphatic system. 
1. Lymphatic varix. 
2. Lymphatic fistula. 
3. Varicose groin glands. 
4. Lymph scrotum. 
5. Chyluria. 
6. Chylous dropsy of the peritoneum. 
7. Chylous dropsy of the tunica vaginalis. 
8. Chylous diarrhoea. 
9. Elephantiasis scroti. 
10. Elephantiasis vulvae. 
11. Elephantiasis of the legs. 
12. Elephantiasis of the arms. 
13. Elephantiasis of the mammae. 
14. Elephantiasis of limited skin areas. 
INFLAMMATORY MISCHIEF, EITHER DIRECTLY OR INDIRECTLY CON- 
NECTED WITH THE PARASITE 
ELEPHANTOID FEVER 
Elephantoid fever is somewhat of a misnomer, as the fever 
is by no means always followed by elephantiasis ; but its meaning 
is now so well known that there is no fear of confusion. 
Fig. 1 shows very well the characteristics of a typical case. 
A filarial subject may be attacked in one of two ways. In the 
one form, after an hour or two of malaise, he is suddenly taken 
with a rigor, which may be exceedingly severe, but which is 
generally of moderate severity. The temperature rapidly rises, 
and the patient feels very ill, with a hot and burning skin and 
sometimes marked nausea. This condition persists for from 
forty-eight to seventy-two hours, and then the temperature falls 
with moderate rapidity, reaching the normal in from twelve 
to twenty-four hours. This fall is often accompanied by profuse 
sweating. In the other form there is no rigor, but there is 
malaise for some hours before the attack. There is also marked 
uneasiness or tenderness in some lymphatic region. The tern- 
