130 
Filariasis in Ceylon 
rarity of a similar affection of the scrotum is a remarkable point, and 
in the female only one case of elephantiasis of the vulva with 
implication of both legs also was noted. Many of the cases bore scars 
of filarial abscesses in the groin, also marks of a previous yaws 
infection. 
Seven cases of hydrocele of suspected filarial origin, but unassociated 
with elephantiasis of the scrotum, and one case only of lymph scrotum 
associated with varicose groin glands, but without any microfilariae in 
the blood, were seen. 
I only encountered two cases of chyluria, both harbouring micro¬ 
filariae in their blood. The absence of any palpable enlargement of 
lymphatic glands in cases with other signs of filarial disease, such as« 
elephantiasis, was a noticeable feature, especially when contrasted with 
the enlargement of these glands which I found almost invariably in 
filariated Fijians. 
In subjects with no obvious signs of filarial disease I found an 
enlargement of the epitrochlear or of the inguinal glands in 3 - l %, 
and of the natives affected in this manner only three, or 7’5 %, had micro¬ 
filariae in their blood. 
Distribution of filariasis in Ceylon. 
A glance at the map which accompanies this paper will convince 
the reader that wherever the microfilaria rate is a high one, there 
also I found a higher proportion of elephantiasis cases than elsewhere. 
This statement is only proportionally true; for example, the micro¬ 
filaria rate—14’2 %—for a certain village—Ambalantota in the 
Southern Province—is a relatively high one, though only three cases 
of elephantiasis were seen in that locality. 
The absence of filariasis in the cool up-country districts such as 
Avisawella, Badulla, Nuwara Eliya and Kandy, is easily explicable 
by the relatively small numbers of mosquitoes capable of acting as 
definitive hosts in these localities, and by the comparatively low mean 
average temperatures such as would effectually prevent the develop¬ 
ment of the filaria at these higher elevations. 
This explanation, however, does not apply to the hot low-lying 
swampy areas of the Southern and Eastern Provinces, and especially 
to the villages of Topur and Muttur, near Trincomalee in the Eastern 
Province, and separated by a distance of but ten miles from each other. 
(See Map.) 
