Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/199

Rh {| These so far are hardly conclusive one way or the other, and a larger number of observations is required.
 * St. Kitts|||32.8|||14|||3||21.0
 * British Guiana|||16.6|||15|||1||6.6
 * Barbados|||12.66|||10|||0||0.0
 * Trinidad|||10.75|||83|||0||0.0
 * Dominica|||7.63|||2|||0||0.0
 * St. Lucia|||7.58|||5|||0||0.0
 * St. Vincent|||6.0|||2|||0||0.0
 * }
 * St. Kitts|||32.8|||14|||3||21.0
 * British Guiana|||16.6|||15|||1||6.6
 * Barbados|||12.66|||10|||0||0.0
 * Trinidad|||10.75|||83|||0||0.0
 * Dominica|||7.63|||2|||0||0.0
 * St. Lucia|||7.58|||5|||0||0.0
 * St. Vincent|||6.0|||2|||0||0.0
 * }
 * Trinidad|||10.75|||83|||0||0.0
 * Dominica|||7.63|||2|||0||0.0
 * St. Lucia|||7.58|||5|||0||0.0
 * St. Vincent|||6.0|||2|||0||0.0
 * }
 * St. Vincent|||6.0|||2|||0||0.0
 * }
 * }
 * }
 * }

Now the question comes to be, Is there any other explanation which will fit into the facts, and will account for the production of tropical elephantiasis, without the necessity of assuming an obstruction by means of filaria? I think that there is. In most of the suggestions, it will have been observed that the explanations generally include some form of inflammatory action, and chiefly lymphangitis, and it is in this direction that I venture to think the solution should be sought. Radclifle Crocker, in discussing the pathology of elephantiasis, both sporadic and endemic, says: “The disease is consequent upon an occlusion of the lymphatic channels of the part affected, independent of the cause and nature of the obstruction, and whether it is at the trunk or periphery of the lymphatic circulation.” I have described one case where obstruction in a main trunk, a pre-vertebral fibrosis, caused extensive elephantiasis, and no doubt similar cases may occasionally be found in the Tropics. But I am inclined to believe that the vast majority of cases of elephantiasis in the Tropics is of peripheral origin, and is due to a lymphangitis arising