238 REPORT OF THE HARVARD AFRICAN EXPEDITION 
to refer to the report of Rose! published from British Guiana upon a peculiar 
modification of the skin about an infection with Wuchereria (Filaria) bancrofti. 
In two cases, he found upon the anterior surface of the forearm, small, rather 
solid, somewhat translucent nodosities of the skin. They contained serum 
and a mixture of red blood corpuscles. In both cases, M icrofilariae bancrofti 
were demonstrated in the contents. ” 
Suganuma * has also reported upon a case of teratoid tumor from the ab- 
domen of a child six months of age, which contained pieces of a nematode 
which may have been Wuchereria bancrofti. The surrounding tissue was said 
to show inflammatory changes with a tendency to malignancy. 
The Calabar swellings due to the migration of Loa loa are, of course, of a 
transitory nature. According to Fiilleborn, they are an evidence of a reaction 
of the host body to Loa antigen (anaphylactic phenomena), but he has not been 
able to produce them by inoculation of extracts of Loa loa into a patient pre- 
disposed to Calabar swellings. Other observers have attributed these swellings 
to the movements of the adults in the tissues or to the discharge of embryos 
into the tissues by a mature female, as puncture of the swellings has some- 
times shown large numbers of embryos in the oedematous fluid. 
Caro? has recently reported upon two cases of Calabar swellings which 
incline him to the view that these swellings are not definitely connected either 
with the migration through the tissues of the adult parasite or with the dis- 
charge of embryos, and he suggests that some toxin or faecal excretions of 
the parasite may be the exciting cause. This view has also been especially put 
forward previously by Ward.°® 
Low,® in connection with the distribution of Loa loa infection in central 
equatorial Africa, points out that he has observed a number of cases of Calabar 
swellings in European missionaries from the Belgian Congo, several of whom 
have had the adult worms in the eye and the embryos present in the blood. 
He remarks that it is no exaggeration to say that if persons reside in these 
localities for more than five years they are certain to become infected. These 
areas are particularly Niangara and Nala in the Haut Wellé Province and 
Ibambi in the Ituri Province. He remarks that the distribution of Loa loa 
extends from southern Nigeria, the Cameroons and the French Congo, into 
the heart of Africa, in the Belgian Congo. 
Fiillebornia (Dracunculus) medinensis. Johnston’ implies that the guinea 
worm iillebornia medinensis is very common in Liberia; in fact it is the only 
parasite and diseased condition which he describes at length in his book upon 
1 Rose: British Guiana Med. Ann. (1923), p. 67. 
2 While this article was in press, Klotz (Amer. Jour. Trop. Med., 1930, X, 57) has reported upon a 
form of nodular fibrosis of the spleen which was believed to have its origin in a slow growth of fibroblasts 
in the vicinity of the malpighian corpuscles through the irritation induced by microfilariae. Although 
the adult filaria was not found at autopsy, he believes from the study of the morphology of the micro- 
filariae in serial sections of the block of the spleen that the parasite concerned was Filaria (Loa) loa. 
’ Suganuma: Jour. Med. Assoc. Formosa (1927), No. 266, p. 4. 
4 Caro: Bull. Soc. Path. Exot. (1927), XX, 977. 
5 Ward: Jour. Infec. Dis. (1906), III, 37. 
6 Low: Trans. Royal Soc. Trop. Med. and Hyg. (1926-1927), XX, 514. 
7 Johnston: Loc. cit., II, 981. 
