Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/206

 Mr. J. Cantlie said he had no idea that he was to be called on to speak, and his knowledge of the subject was limited. The remark that Dr. Low made about not finding cases of elephantiasis in the street was true in all parts of the world. He remembered, after he had been in Hong Kong for five years, writing an article in which he mentioned that he had never seen a case of ovarian tumour in a Chinese woman, or elephantiasis in a man. He had only just written the paper when a man with a very large scrotum applied for treatment, having travelled 1200 or 1500 miles through the country to come to the hospital. The scrotum was removed, and the man went back again, showing himself to all the people on the way, and telling them he had been cured of his tumour, which weighed, on removal, about 49 lb. After that he (Mr. Cantlie) began to think that the majority of the men on the road along which that patient had travelled suffered from elephantiasis of the scrotum, judging by the number of patients who came for treatment ; at least, that appeared to be the case. The surgical aspect of filariasis did not perhaps bear upon the question very closely, but he thought one point had scientific importance, namely, that the situation of the parent worm, or the obstruction, was always proximal to the elephantiasis to which it had given rise. If there was an enlarged filarial gland in the groin the worms laj'- ujjon the proximal side. The question arose. Would the disease from which the patient was suffering be benefited by removal of the glands ? Various cases were reported in which operations had been undertaken for the removal of filarial glands in the groin, notably some cases by Colonel Maitland, of Madras, and the result was that not only were the enlarged glands removed, but the filariae disappeared from the patient's blood. What was to be done in the case of a huge lower extremity ? If the leg were amputated, would the disease be cured ? If the removal of the glands