ELEPHANTIASIS —Gr., WOuc, an eleph an t.
Definition —Elephantiasis is a chronic endemic and sporadic hyperplasia of the skin and subcutaneous tissues, following an inflammatory embolus of the lymph and blood- channels, and resulting in an inordinate enlargement.
Symptoms. — The legs are involved most frequently; the genitalia of both sexes follow closely, while many other parts—the face, body, and extremities —are occasionally attacked.
Case of congenital elephantiasis. 'Men tal development considerably below par. Had congenital hypertrophy of the face, eyelid, and scalp, confined to right side. The right eye had become diseased in volved; the scrotum is affected with greater frequency than the penis in the male, and the labia majora and minora than the clitoris in the female.
Elephantiasis of the vulva observed in a mulatto woman who was four months pregnant. The tumor encroached upon the vaginal orifice so much (the clitoris and labia majors. and minora being all involved) that delivery at term Nvould have been impossible. Henee the mass was removed with the knife, being first constricted Ivith an elastic ligature tied under three long pins passed beneath the tumor. Bleeding vessels were thus se early childhood, and had been removed. The hypertrophy seemed confined chiefly to the skin and subcutaneous tissue; the upper eyelid was greatly thickened and pendulous, reaching down to the upper of the aim nasi. There was a well -marked, irregular depression in the re gion of the squamous portion of right temporal bone, and in one place a slight loss of bony substance. Over the poste rior portion of the right parietal bone was a soft, flabby tumor of the scalp about the size of a. small hen's egg, freely movable, and covered with a nor mal growth of hair. Coley (N. Y. Med. Jour., June 20, '91).
Three cases of elephantiasis of the upper lid, in one of which both eyes were affected. Goraud (Annales de la Polyclin. de Bordeaux, Apr., '92).
The right leg is more often attacked than the left, occasionally both are in euted separately and the wound closed by sutures. Pregnancy was not dis
turbed. Mundi: (Amer. Jour. of Obstet., Oct., '95).
Case of a man, 19 yea.rs old, in whom the foreskin and scrotum began to en large at the age of 4, continuing until it bad reached the enormous size shown in illustration. Operation successfully performed. Uthemann (Deutsche med. Woch., Dec. 5, '95).
F01111 of chronic enlargement of the testes frequently met with in the inhab itants of warm countries, and associated, in many instances, with elephantiasis of the scrotum and lower extremities. This form of testicular enlargement, which is associated with swelling and induration of the epididyinis and sperinatie cord, even when existing alone, is held to be invariably of the nature of elephantiasis, and not due to any malarial influence. After castration and during an opera tion for hydrocele, it has been found that this condition is the result of a dis tension of the lymph-vessels of the tunica albuginea, epididymis, and cord, and of an excessive proliferation of the con nective tissue. IThe filaria undoubtedly plays a considerable part in the genesis of such morbid conditions. Le Dentu (Revue de Chin, Jan., '9S).
No inconvenience or pain accompanies the disease in the majority of cases, but very often when the scrotum is the part attacked stomachic and nervous distress is encountered. Radiating pains may be observed in the seminal nerves, thus causing intense nausea and vomiting. Hydrocele may be induced.
The prodromic stages differ according , to whether the elephantiasis occurs in hot or cold. climates. In hot countries there appears a preliminary fever termed "elephantoid fever," which is preceded by pains of great intensity in the lumbar reg,ion, accompanied with retching and vomiting, cold shiverings located along the spine, followed by fever and profuse perspiration in successive alternations.