19. 3 
Maxwell: Filariasis in < China 
301 
lene blue, glycerin, perchloride of iron, chromic acid, quinine, 
sodium salicylate, and ichthyol. 
The best results in the treatment of the disease are to be ob- 
tained from general treatment. The patient should be placed in 
bed, and absolute rest should be prescribed; as the patient does 
not usually feel very ill, this absolute rest is by no means easy to 
obtain. The pelvis should be elevated, and the amount of food 
and drink should be restricted. The bowels should be well 
cleared out. 
If a minimum of fatty and fluid food is administered, the 
milky character of the urine may quickly pass away. This 
does not necessarily mean that the fistula is closed, as I have 
previously stated; but very often, by the above treatment the 
fistula can be really got to close and remain closed, sometimes 
for many months. 
The subjects of this affection should beware of excessive or 
very violent exercise, as it is probable that an attack may be 
precipitated in this way (see next section ) . Special care must 
be taken by women during pregnancy, as the extra strain of 
labor is not at all unlikely to bring on an attack in susceptible 
subjects. 
Clots of large size form occasionally in the bladder and give 
much trouble in the way of retention. When this occurs they 
may be easily broken up with the aid of a metal catheter. 
CHYLOUS DROPSY OF THE PERITONEUM 
Chylous dropsy of the peritoneum is extremely rare. Win- 
kel(45) records a case that was probably of this nature. The 
first serious symptom was the development of ascites. The fluid 
drawn off by tapping was of a milky character and contained 
what were probably filarias. Afterward the patient developed 
swelling of the left leg, which gradually subsided. The ascites 
returning, she was again tapped, and fluid of the same character 
was. drawn off. Two days later she died suddenly. 
One case has come under my care. The patient was a man 
of middle age, who had suffered from elephantoid fever. After 
a wine party he went outside and “saw a demon.” He was 
greatly frightened and ran all the way home, a distance of three- 
quarters of a mile (1.2 kilometers) . He felt uneasy in the abdo- 
men on reaching home, and by morning it was swollen. A week 
later he came to hospital. His abdomen was moderately swollen 
by free fluid. On tapping, milky fluid was drawn off, but no 
filaria was found in it. The patient refused treatment and left 
