Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/183

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THE PRODUCTION OF DISEASE.
155

puffiness. I saw him in October, 1907. There was then itching and puffiness of dorsum of right foot, which disappeared in a couple of days. Since then there has been no recurrence.

Case 2 has had similar attacks of itching, followed by swelling, but these have occurred on many parts of the body, head, arms, hands, feet, and legs. The symptoms were first noticed three and a half years ago. When the adult first passed over the eye, it caused a tickling, followed by soreness. It was last seen in June, 1907. I saw him in November, 1907. There were then no signs of any kind, and there has been no recurrence, it is interesting to note that with the onset of the cold weather the worm does not appear to come near the surface, and the cutaneous phenomena cease.

Case 3, the one in which I have found embryos; there have been no typical swellings, though the patient said that he had a swelling of the left wrist in July, 1907, which persisted for some time. He suffers, however, from a peculiar cutaneous irritability. Parts of his body itch, he scratches and causes excoriations, with here and there small subcutaneous, reddish maculae. Otherwise his general condition is good. In none of these was there any glandular enlargement.

In a paper in the Journal of Tropical Medicine (November 16, 1903, p. 347), Sir P. Manson describes cases of Calabar swelling occurring in the Congo, and suggests their relationship to F. loa ; and Dr. Habershon, in the same journal, also cites cases where the association of localized swelling was noticed. In the original case of F. loa described by Dr. Argyll Robertson, swelling of the legs and arms was also observed.

I think, then, that we have now a sufficient number of recorded cases to justify us in associating the presence of F. loa with Calabar swellings, but I am inclined to