Result of rupture of lymphatics. Milky, fatty lymph. Treatment,
ligature, excision, cauterization, of little avail. Compression.
Tonics.
Obstruction of a lymph duct may lead to rupture and the discharge of its
fluid on the surface or into an internal cavity. Dr. Cayley records a
case of fatal peritonitis in man from rupture of the receptaculum chyli,
and the formation of lymph fistulæ has been attributed to filaria
sanguinis hominis. We are aware of no corresponding case in connection
with the blood parasites of the horse or dog. In the larger domestic
animals the great thickness and resistance of the skin offers a barrier
to the rupture of subcutaneous lymph vessels, but this no longer applies
in case of a suppurating or ulcerous wound. The escaping lymph has often
a milky hue from the admixture of fat, just as its escape in the kidneys
causes chyluria, and in the bowel fatty stools. The escape is often very
profuse and persistent, and results in marked debility. Ligature and
excision of the fistulous vessel, also caustics—actual and potential,
have been tried with rather poor success. Fitzer succeeded in an
obstinate case by the extensive application of nitrate of silver and
others by simple compression. As the victims are usually debilitated a
course of tonics is usually desirable.