Filarial orchitis.— Several French writers describe under the name " malarial orchitis " a special form of inflammation of the testes, and here and there in Indian medical literature allusion is made to the same or a similar subject. " I have many times seen filarial orchitis, but I cannot say I have seen orchitis of purely and unquestionably malarial origin. The fever attending filarial orchitis which is usually associated with lymphangitis of the spermatic cord (funiculitis) and perhaps with inflammation of the scrotum like ordinary elephantoid fever resembles very closely a malarial attack, and may be mistaken for this. Without absolutely denying the existence of such a disease as malarial orchitis, I would suggest that the affection described by the French and Indian writers referred to, and endemic inflammations of testes, spermatic cords, and scrotum generally, are of filarial origin.
Filarial synovitis.— Maitland mentions acute synovitis of the knee-joint as one of the filarial diseases, and gives the particulars of five cases. He considers the concurrence of synovitis with filarial invasion too common to be accidental. Bahr has confirmed this, and has found that ankylosis often results. In cases where the hip- joint is affected, removal of the inflamed iliac glands draining the area appears to relieve the condition.
ELEPHANTIASIS
Its prevalence.— Elephantiasis is by far the most frequent manifestation of filarial invasion, and is exceedingly common in some of the endemic districts. Thus, in certain districts in Cochin about 5 per cent, of the population, in Samoa about every second individual, in Huahine seven-tenths of. the adult male population are affected. In many other tropical and sub-tropical countries, if not so common as in those just mentioned, elephantiasis is, nevertheless, common enough.
Parts affected.— In 95 per cent, of the cases the lower extremities— either one or both— alone, or in combination with the scrotum or arms, are the seat of
