in the groin cured the systemic disease in Colonel Maitland's cases, would the removal of the lower limb in elephantiasis do the same thincr ? Colonel Maitland's cases were well known and they deserved careful consideration, from a surgical point of view, as a method of cure. With regard to the length of time that a man might have filariae in the blood and not develop elephantiasis, he knew of a case in London which the Chairman had also seen, in which the patient had had filarial worms in his blood for twenty-two years, and still had no sign of elephantiasis' yet in all probability he would eventually get the disease. The man was born in the Straits Settlements, and possibly had tilariae in his blood from childhood ; but that case did not prove that elephantiasis had nothing to do with filaria. According to the theory of Sir Patrick Manson, if the parent worm were uninjured, elephantiasis would not result ; it was only when the channels were blocked up that elephantiasis ensued. In this case no injury had occurred, and therefore the parent worm had not aborted and blocked the parts. Filarial infection might be present without the patient or physician knowing it. It might show itself as a tumour or an abscess in any organ of the body, or in a hydrocele, or in chyluria, or in enlarged glands. He remembered visiting a man who had swollen glands in the groin, a plague tongue, with a high temperature, and who was delirious ; there was plague in the house. The man was sent to the plague hospital, where he passed urine which was examined under the miscroscope. It was then ascertained that the man had chyluria, and was suffering from filarial fever with enlarged glands.
Fleet-Surgeon Bassett - Smith described a case of scrotal disease in a marine. He believed it to be syphilitic, but in every way it closely resembled elephantiasis, and the diagnosis was doubtful, as the man had been for so n:e time in China.
