A system of surgery . S AND DISEASES OF LYMPHATICS. the name given by Dr. Manson to a condition in which both groinsare occupied by large obscurely lobulated swellings, which to the touch feel boggy, doughy, semi-fluc-tuating, with here and there a firmerkernel-like lump, from Avhich a needlewill extract chylous or Jymphous are due to filarial obstruction ofthe thoracic duct. (2) Lymph scrotum—elephantiasisscroti — results from the pluggingof the upper group of the super-ficial inguinal glands if anastomosis isnot established. It attacks Euro-peans, but is much more frequentamong n
A system of surgery . S AND DISEASES OF LYMPHATICS. the name given by Dr. Manson to a condition in which both groinsare occupied by large obscurely lobulated swellings, which to the touch feel boggy, doughy, semi-fluc-tuating, with here and there a firmerkernel-like lump, from Avhich a needlewill extract chylous or Jymphous are due to filarial obstruction ofthe thoracic duct. (2) Lymph scrotum—elephantiasisscroti — results from the pluggingof the upper group of the super-ficial inguinal glands if anastomosis isnot established. It attacks Euro-peans, but is much more frequentamong native races. The conditioncommences by an attack of inflamma-tion, accompanied with elephanloidfever (Fayrer), which differs from thefever of malaria in the irregularity ofthe attacks, and in the greater lengthboth of the febrile paroxysm and ofthe intervals. This is followed by adischarge of lymphous or chylous fluid,which recurs at intervals. The scrotumis red and enlarged, and its surfacevesicles,sanguino-which. Fig. 190.—Lymph Scrotum. (Maiisou.) covered with herpes-likefrom which a milky orlent fluid escapes, and inalmost invariably living filarise areto be detected. These conditionscontinuing, the skin of the scrotumand penis becomes rough and coarse,and gradually the parts attain enor-mous size, until the scrotum reachesa weight of 10, 20, or 30 lbs., whilstmasses weighing 110, 140, and even224 lbs. have been recorded. Thetumour is pear-shaped, with its nar-rowest part at the pubic and perinealattachments. The testes are draggeddown and are found at the back part,considerably below the middle of thetumour. The penis is to be distin-guished at the upper part of the neckof the mass at the extremity of atunnel formed by the hypertrophiedskin of the penis and prepuce (Fig.!90). The weight of the tumour draws down the skin of the abdomenand alters its form. The discharge from the varicose lymphatics
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Keywords: ., bookcentury1800, booksub, booksubjectsurgicalproceduresoperative
