Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/191

Rh the dead worm. But there is a point that does not appear to have been sufficiently considered, and that is, that in a population with a general degree of filarial infection, death in the adult worm must be constantly taking place, unless we are to assume that once the worm is in the body its life is limited only by the life of the individual. Given a definite infection of, say, 25 per cent, in a population, and a definite life-history of the worm, death must be constantly occurring at about the same rate, viz., 25 per cent., and we should expect a similar proportion of "filarial abscesses" to occur. But I am unable to find any evidence of this. Glandular and lymphatic abscesses are undoubtedly more common in natives of tropical countries (not, I believe, among Europeans), and for the same reason that ulcers are more common, there is more opportunity of streptococcal infection. Natives go about bare-footed; wounds and abrasions are more common—these are not attended to — their habits are not always cleanly, and we have the natural result of a septic infection. It is very rare to find a native without traces of scars on the legs.

The literature of filarial abscess is not plentiful, though there are frequent references in several papers, but I have found an interesting paper by Dr. Preston Maxwell, on which I should like to say a few words. Dr. Maxwell attributes his cases to death of the parent worm, and gives a table showing twenty-three cases of abscess, which he calls filarial, and the only evidence which I can find is the presence of embryos in the blood, which is no proof at all in a highly-infected community, as it would be necessary to show that abscess occurred more frequently among infected individuals than among the general community. In only one case out of the twenty-three was the remains of a worm found, though a careful search was made—surely a very low proportion. It is difficult to believe that disintegration and absorption can take place so rapidly