A. C. Parsons 
367 
cerns them. To my knowledge pyrexia is unknown in connection with 
this form of filariasis. The only symptoms likely to occur are those 
caused by pressure. In one of my cases, I was asked to remove 
a tumour because it was unsightly and interfered with the proper 
disposition of the child’s clothes. Treatment is simple and, if the 
‘ disease ’ is merely local, effective. The tumours in themselves are 
easily enucleated with the aid of a little local anaesthesia: all the 
growth should be removed cleanly and intact. 
Conclusions. 
1. Time will probably show that F. volvulus is more common than 
has hitherto been supposed. 
2. Analogy would lead us to suspect that F. volvulus is transmitted 
by some blood-sucking insect. 
3. The geographical distribution of F. volvulus, as at present known, 
seems to correspond more or less with regions in Tropical Africa that 
are associated with such insects as have been proved to act as carrying 
agents in other parasitical affections. 
4. While the adult male worm has been studied more or less com¬ 
pletely, this does not hold for the female worm. The difficulty lies 
in the extraction of the worm from the tumour: the tail portion is 
nearly always left imbedded in the fibrous stroma and defies detection. 
What seems to be needed is some macerating medium in which the 
tumour would disintegrate without the worms becoming destroyed. 
As regards preservatives a weak solution of Formalin proved very 
satisfactory, in the author’s case, for preserving the tumours during 
transit. 
5. Although the embryos of F. volvulus have not yet been found 
in the peripheral blood, it seems highly probable that some part of 
their existence must be spent in the general circulation. 
Finally, I should like to acknowledge the kindness of the authorities 
at the London School of Tropical Medicine who allowed me to work in 
their excellent research laboratories. To Dr Leiper in particular I am 
much indebted, not only for the valuable help he so generously 
extended me, but also for his courtesy and friendly criticism. 
