152 
FILARIA MEDINENS1S. 
and the right side of the neck, had finally taken up its 
quarters in the corresponding side of the thorax; that this 
migration had occupied many days, and had been accom¬ 
panied by a curious sensation of commingled tingling, 
itching, and pain, below the skin, which in some places, and 
especially in the temporal and frontal regions, showed a 
slight elevation, manifest to the sight and touch, and indi¬ 
cating the track of the dracunculus. 
On examining the region pointed out by the patient as 
the seat of the worm, I found immediately below and outside 
the right nipple, and in a space more or less of the size of 
the palm of the hand, a number of irregular curvilinear 
elevations, crossing one another in various directions, like 
the loops of a cord or thick thread wound up below the skin ; 
he had had for some time back no pain on pressure, nor any 
other disagreeable sensation, but, fearing the terrible 
accidents he had seen undergone by others suffering from 
the same affection, he urged me to extract the worm; this I 
refused, advising him to call in a surgeon that I named; he 
preferred, however, procrastinating, and left for Joazeiro. 
The following year Oliveira returned to Bahia; the 
elevations, which he assured me were produced by the 
curling up of the worm, had disappeared, either because the 
worm, having died, had been gradually absorbed, or because 
it had migrated to some deeper locality. Never again, at all 
events, did it give any evidence of its existence up to the 
time of Oliveira’s death, five or six years afterwards, from, I 
believe, some disease having its origin in marsh miasm, 
accompanied by ansemia, anasarca, &c. 
In the course of the same year, 1850, and some months 
after my seeing for the first time this patient, his brother 
Manoel (whom two years ago I saw in Portugal, where he 
has resided for the last ten), came to Bahia and showed me 
his right thigh, affected with what looked like phlegmonous 
erysipelas, a state which had already lasted for several 
weeks, and had much annoyed him on his journey of eight 
or ten days on horseback. A small abscess during the 
journey had broken at the lower and inner part of the thigh, 
giving issue to part of the filaria, which then broke across. 
Soon after his arrival here the worm again made its appear¬ 
ance at the same opening, and in the course of a few 
days I extracted it without any difficulty, the fistula healing 
up and the phlegmonous inflammation disappearing, leaving 
only the mark of a small cicatrix still visible to this day. 
These two facts, and others related by my patients, as 
witnessed by them in the persons of those who had accom- 
