Filariasis and elephantiasis in Fiji ; being a report to the London School of Tropical Medicine.
- Manson-Bahr, Philip Heinrich, Sir, 1881-
- Date:
- 1912
Licence: In copyright
Credit: Filariasis and elephantiasis in Fiji ; being a report to the London School of Tropical Medicine. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
101/220 page 79
![t 79 Quinine bihydrochloride, five grains in 2 c.c. distilled watei', also intravenously, had no appreciable effect on the microfilariae. O'Brien has reported a case in which after injection of atoxyl the microfilariae decreased in numbers, but did not entirely disappear. His figures are not very convincing. Leber and Prowazek noted no diminu- tion in their numbers following on injections of thymol, quinine, methylene blue, and 606 Treatment of enlarged glands by radium has been advocated by ,-Havelock Charles; the glands in his case diminished in size, but as to any effect on the number of microfilariae, no mention is made. Injection of Staphylococcus aureus vaccine (obtained from a filarial abscess) was tried as a sort of forlorn hope, on the speculation that the absorption of the toxins of pyogenic organisms might have some pre- judicial . influence on the microfilariae ; the result was negative (Appendix XXXII. and charts). XXV. The absence of microfilanae from the blood in the case of undoubted infection with living filariae requires explanation ; a similar apparent anomaly occurs in other filarial infections in man, e.g. in Filaria loa and in Filaria volvulus. In a case reported by Argyll-Robertson'^ of an adult male of Filaria loa in the eye, and which was described by Manson, no microfilariae were found in the blood, although the patient suffered from Calabar Swellings and a gravid adult female worm was subsequently removed from the eye. Thompstone'^ described Calabar Swellings as occurring frequently in cases where no microfilariae could be found in the blood. Low^ describes several cases in which the ])atients suffered from Calabar Swellings, and in whom there was j^roof of the presence of this parasite, yet no nncro- filariae could be found in the blood. Manson^ also describes several instances of a similar nature, and commenting on the fact, observes that :— (1) The microfilariae may be present in the blood in numbers so small as to be missed. (2) The microfilariae may be only intermittentl}' discharged from the parental uterus or intermittently circulating. Lastly, Manson^^ in a case with microfilariae and Calabar Swellings was able to demonstrate in great numlsers microfilariae in a drop of tissue juice obtained by aspiration from the centre of one of the swellings. This fact lends support to his hypothesis that the emission of the embryos by the parent worm into the connective tissue is the cause of these swellings. He considers that these swellings represent a tissue reaction in the interests of the parasite, since it must lead to a flow of lymph to and from the part in which the microfilariae are emitted, and so assist them to reach the circulation. This does not explain, however, the absence of micro- filariae from the blood in those numerous cases in which the Calabar Swellings are of frequent occurrence, yet no microfilariae can be found in the circulation, it may be for years after the first attack and while the swellings continue to recur. If this pathological effect of the parasite be really produced in the way Manson has conjectured, then in a very large proportion of those coses the object, so to speak, of the act—namely, the lodgment of the embryos in the blood—is defeated, and we must conclude that it is thwarted by some other factor, of which we are still ignorant.](https://iiif.wellcomecollection.org/image/b21356658_0101.jp2/full/800%2C/0/default.jpg)
