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724 length being dissected off. Charles advocates complete resection of the whole of the elephantoid tissue except the sole of the foot, followed by extensive skin-grafting. Electrolysis and mercury have also been used; I question their value. During the acute attacks, tension may be relieved by aseptic punctures with a sharp lancet. At all times the limb must

Fig. 119.—Elephantiasis of legs; scrotum and right arm also affected. (Photograph by Dr. Turner, Samoa.).

be carefully guarded from injury, and shoes and trousers worn. Slight injuries provoke the inflammatory recurrences. Wading in water, prolonged standing, violent exercise, and exposure to a hot sun are injurious and should be avoided.

Handley has brought forward an operation, lymph-angioplasty, the underlying principle of which is the drainage of an area of lymph stasis into an adjacent patent lymphatic area by means of strands