of elephantiasis, chyluria, and lymph scrotum, which is thoroughly
worthy of consideration. Our readers are probably aware that the parent
filaria and the filaria sanguinis hominis may exist in the human body
without entailing any apparent disturbance. The diameter of an
embryo filaria is about the same as that of a red blood disk, one
three-thousandth of an inch. The dimensions of an ovum are one
seven-hundred-and-fiftieth by one five-hundredth of an inch. If we
imagine the parent filaria located in a distal lymphatic vessel to abort
and give birth to ova instead of embryos, it may be understood that the
ova might be unable to pass such narrow passages as the embryo could,
and this is really the hypothesis which Manson has put forward on the
strength of observations made on two cases. The true pathology of the
elephantoid diseases may thus be briefly summarized: A parent filaria in
a distant lymphatic prematurely expels her ova; these act as emboli
to the nearest lymphatic glands, whence ensues stasis of lymph,
regurgitation of lymph, and partial compensation by anastomoses of
lymphatic vessels; this brings about hypertrophy of tissues, and may go
on to lymphorrhoea or chyluria, according to the site of the obstructed
lymphatics. It may be objected that too much is assumed in supposing
that the parent worm is liable to miscarry. But as Manson had sufficient
evidence in two cases that such abortions had happened, he thinks it is
not too much to expect their more frequent occurrence. The explanation
given of the manner in which elephantoid disease is produced applies to
most, if not all, diseases, with one exception, which result from the
presence of the parasite in the human body. The death of the parent
parasite in the afferent lymphatic may give rise to an abscess, and the
frequency with which abscess of the scrotum or thigh is met with in
Chinese practice is, in Manson's opinion, attributable to this. Dr.
Manson's report closes with an account of a case of abscess of the
thigh, with varicose inguinal glands, in which fragments of a mature