On a case of elephantiasis arabum (elephas) : successfully treated by the application of a ligature to the main artery of the limb : with remarks / by Thomas Bryant.

  • Bryant, Thomas, 1828-1914.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On a case of elephantiasis arabum (elephas) : successfully treated by the application of a ligature to the main artery of the limb : with remarks / by Thomas Bryant. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    14/20 (page 12)
    The pathological observations 1 have been able to make tend to prove the accuracy of these views, although it must be added that the condition of the veins, which Dr. Wilks has described as being thickened in the true West Indian example of elephas, is not the usual one as found in the majority of the cases occurring in this country. I had an opportunity of seeing the case described by Dr. Wilks, and the thickened patulous mouths of the veins in the diseased tissues were very marked, but in no other of the half-dozen or so of cases which I have been fortunate enough to see was the same condition present. The case I have just brought before your notice tends to prove the fallacy of the opinion that this affection is due to an inflammatory thickening of the veins of the extremities, for the foot, it will be remembered, was uninvolved in the disease, and was quite free from all oedema ; such a condi- tion could hardly have existed had the enlargement of the limb been due to an obstruction of the main venous trunk, for oedema of the most dependent part would, under such circumstances, be looked for as an early symptom. The microscopical elements of this thickened tissue are mostly uniform in all cases, for free nuclei, cells, and fibres, in all stages of growth and of development, are invariably to be found; the skin and cellular tissue appearing to be infiltrated with the same elements as go to build up a fibro- plastic tumour, the microscopical elements of each being of the same nature ; the formative process in the cases of elephas appearing in excess as a diffused disease of the cellular tissue, and in the more common fibro-plastic tumour as a local one, excess of nutritive material and of orgauiz- able products existing in both. Under these circumstances the principle of the operation I have just brought before your notice must be looked upon as rational, and the practice based upon it as scientific ; for if the disease of ele2>has be due to an abnormal effusion of tissue-making elements, to an excess of nutrition in a limb, the attempt to check its progress by the application ot a ligature to the main arterv bv which it lives must be * V