(Filaria Sanguinis-Hominis)
There are two varieties. One is a thread-like worm with tapering, blunt
ends, appearing in the blood at night, hence called =nocturna=, while
the other is of slightly different form, appearing in the blood only by
day and is called =diurna=.
The mosquito is the communicating host of the parasite. During the
night, or should the patient sleep during the day, the =nocturna=
appears in the peripheral circulation, while during the other interval
they are probably in the other vessels, particularly the lungs.
After the mosquito has taken blood from an affected patient it requires
from six to seven days for the metamorphosis of the minute filaria
which are then lodged in the probosis of the mosquito and introduced
into the blood of the next victim. The adult parasite is from three to
four inches long and the thickness of a coarse hair, with clear sexual
distinction.
=Pathologically= there are no distinct lesions, as the parent worm
must establish one. Lymphatic engorgement may result from plugging of
the thoracic duct or of a large lymphatic with consequent engorgement
which may develop symptoms in the inguinal glands, pelvic and lumbar
lymphatic trunks. As these varicosities develop rupture may occur; if
into the genito-urinary tract chyluria or chylocele may result, or if
in the abdominal cavity chylous ascites.
Lymphangitis follows a lymph stasis, which later results in
=elephantiasis=. (Barbadoes leg.)
=Symptoms.=—Elephantiasis affects the legs, but the arms rarely; the
labia of the female and scrotum of the male; occasionally the breasts
and other parts of the body. Fever is present on account of the
lymphangitis, accompanied by rigors and delirium and there is marked
local inflammation. The attack terminates in a pronounced sweat. In
deeper parts there is deep seated pain and signs of sepsis, while
abscesses may develop over the inflamed area.
The varicose inguinal glands are doughy, soft and painless, with both
sides affected alike. The scrotum is affected by the extension, and at
times the testes.
=Treatment= is surgical, as the tumors must be removed. Unless the
female worm is also removed this is, however, only palliative.
Methylene blue is said to be destructive to the filaria and it is
practically harmless to the human body. The only treatment is one that
will aid in building up the general health.