19 , 3 
Maxwell: Filariasis in China 
275 
both legs were the subject of bad contracture. The cellulitis 
had also left him with lymphatic fistulse on the outer surface 
of each thigh. Both legs were the subject of elephantiasis, and 
the condition of the man was miserable beyond description. 
He was extremely anaemic and died of exhaustion ten days 
after entering the hospital. 
In rare cases the dermatitis becomes ulcerative. Of this 
only one good instance has been seen by me. It is always 
the result of infection of the bullae which are apt to form on 
the surface of a limb that is already affected by erysipelatoid 
inflammation or the like. It must be treated like any ordinary 
ulceration, its pathology being precisely the same. 
ABSCESS 
Abscess of the scrotum is a disease by no means common in 
England even when we include tuberculous abscess connected 
with the epididymis and testicle, and it was a cause for some 
surprise and not a little incredulity to be confronted, soon after 
arrival in China, by a patient whose scrotum, swollen to the 
size of a foetal head, appeared to be little more than a bag 
of pus. 
The history of this patient was a curious but at the same 
time a typical one, although at the time it was not known 
to be such. Fifteen days previously, while at work, he had 
been seized with a violent rigor, which lasted about ten minutes 
and' then passed into fever, which had been persistent since. 
He was cognizant of no previous illness, and denied any attacks 
of lymph fever, stating that he had been a strong man all his 
life. He was aged 42 years. He refused to come into the 
hospital, and I was unwilling to operate in his dirty hovel. 
Eventually part of the scrotum sloughed, and after a long illness, 
the man recovered. He was, however, subsequently troubled 
by attacks of elephantoid fever. 
In seeking for the cause of this and subsequent cases of a 
like nature, gonorrhoea could easily be excluded, as not more 
than 30 per cent of the patients confessed to having had it. 
None of them had stricture of the urethra, and the orchitis, 
when present, was slight ; in many cases it was absent. Besides 
the fact that the abscesses were mostly outside the testicle and 
seminal tract, the further knowledge that Morris 7 did not men- 
tion such an affection put it almost out of court. 
7 Diseases of the Urinary and Generative System. Cassell, London 
( 1895 ). 
