19, 3 
Maxwell: Filariasis in China 
277 
Dr. J. H. Montgomery has also found a parent worm in a 
case of this nature that came to him at Choanchiu, Fukien. 
Some cases are probably due to causes other than the death 
of a parent worm. I was fortunate enough to be able to ob- 
serve the whole process in a patient, who was in the hospital 
for a trivial affection. Within the space of a few days he had 
an attack of filarial lymphangitis of the cord on both sides of 
the scrotum; one side came to suppuration, the other did not. 
Both, at the outset, presented exactly the same appearance, 
the inflammatory process on the one side being apparently 
much the same as on the other. 
On two other occasions, by promptly putting the part at rest 
and applying cold, the inflammatory process has been aborted. 
As a rule, a sharp local attack leads to the formation of pus. 
There is another fact that has to be taken into account in 
considering the pathology ; namely, that some of these abscesses 
in the scrotum are suppurating hydroceles. In such a case it 
is difficult to see where the death of a parent worm can come 
in, as parent worms have never been found inside hydroceles. 
One is inclined to think that the majority of these are due to a 
local cause and are probably connected with the blocking of lym- 
phatic vessels ; but there is no evidence to offer in support of this 
view save the fact that in some cases the abscess is the first 
manifestation of an affection that ends in elephantiasis of the 
scrotum or of the affected limb. In others it certainly does not 
end thus, but possibly this is due to the fact that a lesser area 
of the lymphatic system has been interfered with. 
FILARIAL ABSCESS 
Passing from the pathology of the disease to its clinical form 
and diagnostic point, these abscesses may be classified as 
follows : 
Filarial abscess : 
A. Of the scrotum. 
1. Suppurating hydrocele. 
2. Abscess of the cord. 
3. Abscess below the testicle. 
B. Of the limbs. 
C. Intra-abdominal or intrathoracic. 
Concerning the cases contained in A, the division may seem 
at first sight to be arbitrary and unnecessary. A further con- 
sideration will show that it is not really so. Commencing in 
the way that is common to all abscesses, they follow different 
courses and each must be treated in a different way. 
