On a case of elephantiasis arabum (elephas) : successfully treated by the application of a ligature to the main artery of the limb : with remarks / by Thomas Bryant.

  • Thomas Bryant
Date:
1866
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Licence: Public Domain Mark

Credit: On a case of elephantiasis arabum (elephas) : successfully treated by the application of a ligature to the main artery of the limb : with remarks / by Thomas Bryant. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    cutta,5 vol. viii), looked upon the disease as one of the venous system, and, what is more, as inflammatory; the evidence he adduces, however, to support this theory is not satisfactory. Some authorities are disposed to regard the disease as one of the absorbent and lymphatic glandular system ; others as a chronic inflammatory thickening of the skin and cellular tissue. Dr. Carnochan, in his memoir, men- tions a condition which he looks upon as a fact—although he fails to give us the grounds of the opinion—that the disease is due to the morbid condition and dilatation of the principal arterial trunk of the member affected, and it was upon this idea that he was led to adopt the practice which the cases quoted appear to justify, although the observation as to the dilatation of the main vessel of the diseased limb has yet to be confirmed. In the case I have just recorded the condition of the iliac vessel appeared to be sound, and in a second, in which I performed amputation of the leg in the year 1864, the vessel was also good. In all of Dr. Carnochan5s own cases, with the exception of the first, the femoral artery has been described as being healthy. What, then, it may be asked, is the pathological condi- tion of a limb the subject of elephas? Dr. Wilks has described it “ as a disease due to an exudation of lymph into the skin and subcutaneous tissue, whereby the former is -hypertrophied and an immense thickening is produced beneath it, and, at the same time, the fat is often much increased in quantity. The skin also becomes brown, and a number of fissures occur, which subsequently change to oozing ulcers. In a true West Indian example of this affection the cuticle was found very much thickened and of a dark colour; the cutis was also thickened, and beneath there was a quantity of adventitious fibrous material and fat. The bones were healthy, and the veins leading to the diseased parts were exceedingly thickened. The state of the lymphatics was not made out.” (Wilks5 f Pathological Anatomy,5 p. 177.)
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