235


CHAPTER  XV.
ELEPHANTIASIS.
Synonyms :  ElephantioM  ArabHtn,  Bncnemia^  Barbados  leg,  Coehin  eg^
Egyptian  Sareocele,  Tropical  bufleg,  Natoid  UlephatUiasit,  Varix  lym-
pkutiouty  Lymph-teratum,

Elephantiasis,  whether  affecting  the  limbs  or  genitals,  is
the  same  disease,  and  if  of  long  standing  its  effects  are  not
limited  to  external  changes,  but  disease  of  internal  organs
will  be  found.  It  may  be  defined  as  consisting  constitution-
ally of  a  peculiar  fever  recurring  at  irregular  intervals  ;  and
locally  of  hypertrophy  of  the  skin  and  subjacent  areolar
tissue,  due  to  adventitious  deposits,  accompanied  by  deterio-
ration of  blood,  and  change  of  structure  in  internal  organs,
particularly  the  spleen.
Elephantiasis  is  frequently  seen  in  Western  India,  but  is
perhaps  more  common  in  Madras  and  Bengal.  In  Cochin,  Day
stated  that  about  one  in  seventeen  of  the  native  Christians
are  affected,  and  of  the  Portuguese  about  one  in  eighteen.
Waring  stated  that  in  Cochin  scarcely  a  house  is  free.  Even
in  such  districts  it  is  more  prevalent  in  low  damp  situations
near  the  sea-coast,  or  in  the  neighbourhood  of  marshes,  or  in
any  place  where  tainted  or  malarious  atmosphere  might  be
expected.  Others  have  regarded  elephantiasis  as  limited
to  the  rice-producing  countries,  which  are  chiefly  the  tracts
near  the  sea-coasts.  Chevers  states  it  always  occurs  within
the  range  of  the  searbreeze,  and  that  it  is  never  developed


236  ELEPHAXTIASIS.
up  country  or  beyond  the  limits  of  the  growth  of  the  cocoa-
nut  tree.  Manson  asserts  that  the  geographical  distribution
of  elephantiasis  is  the  same  as  that  of  the  mosquito.  The
truth,  however,  is  that,  while  occurring  in  the  interior,  it  is
more  prevalent  on  the  sea-coasts.
