Elephantiasis arabum / by Sir J. Fayrer and D'Arcy Power.

  • Fayrer, Sir Joseph, 1824-1907.
Date:
[1879]
Catalogue details

Licence: Public Domain Mark

Credit: Elephantiasis arabum / by Sir J. Fayrer and D'Arcy Power. 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.

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    arrest the disease, and perhaps, but this is douhtful, even disperse any incipient structural change that may have occurred. This has occasionally been observed in rare cases in Europeans, that returning to Europe, they have, after a time, lost the disease, and almost, if not entirely, any hypertrophic changes that may have occurred. Natives of India improve, and the disease often ceases to progress, if they leave the endemic area duriug the early stages and reside in other and drier localities. Such a change, for example, as from Calcutta to Delhi, in the case of a native of Bengal, is often effective in arresting, if not in curing, the disease. It is constantly observed, however, that after the hypertrophic condition had become advanced, the paroxysms of fever are still liable to recur, even when the climate is changed, though they do so with less violence, showing that the tumour itself acts in some way as the source of a dyscrasia that perpetuates the recurrence of the febrile state, which does not cease altogether until after it has been removed. This, where the disease affects the genital organs, is possible. When the limbs are the seat of the disease, it is not so. The onset of elephantiasis is frequently violent and attended with great suffering. There is high fever, intense pain in the lumbar region, the groin, the spermatic cords and testes, which become much congested and swollen, whilst acute hydroceles form. This is often attended with sympathetic vomiting, nausea, rapid and erythe- matous swelling of the external parts; and if the extremities be attacked, the swelling is often very tense and painful, accompanied by much effusion into the areolar tissue. The surface of the integu- ment in much inflamed, and sometimes discharges a serous ichor or chyle-like fluid, according to the extent to which the lymphatics are involved in the particular case. There is much constitutional dis- turbance, increase of temperature, and often depressing nausea and vomiting when the cords are implicated, when the great tension and swelling of the cords is apt to dilate the abdominal rings so widely, that when it subsides after recovery, the patient is liable to suffer from hernia through the widened inguinal passages. During the fever and excitement, salines and aperients, with local soothing applications, fomentations, and often opiates, are necessary to relieve pain and give rest. When this stage has passed, quinine is useful, and if ansemia exist it should be combined with iron, which may be all the more necessary if other indications of malarial cachexia be present. Many remedies have been recommended,