ELEPHANTIASIS (Barbadoes leg; Boucnemia)

This article appears in Volume V09, Page 262 of the Encyclopedia Britannica.

Encyclopedia Britannica - Main :: ECG-EMS

ELEPHANTIASIS (Barbadoes leg; Boucnemia) , is a disease dependent on chronic lymphatic obstruction, and characterized by hypertrophy of the skin and subcutaneous

tissue

TISSUE (Fr. tissu, tissue, participle of tisser, Lat. texere, to weave)

. Two distinct forms are known, (I)

elephantiasis

ELEPHANTIASIS (Barbadoes leg; Boucnemia)

arabum, due to the development of living parasites, filaria sanguinis hominis (or filaria Bancrofti), and (z) the non-filarial form due to lymphatic obstruction from any other cause whatsoever, as erysipelas, the deposit of tuberculous or cancerous material in the lymphatic glands, phlegmasia dolens (white leg), long-continued eczema, &c. The enlargement is limited to a particular part of the

body

BODY

, generally one, or in rare cases both of the lower limbs, occasion-ally the scrotum, one of the labiae or the mammary gland; far more rarely the face. An attack is usually ushered in by febrile disturbance (elephantoid fever), the part attacked becoming rapidly swollen, and the skin tense and red as in erysipelas. The subcutaneous tissues become firm, infiltrated and hard, pitting only on considerable pressure. The skin becomes roughened with a network of dilated lymphatics, and vesicles and bullae may form, discharging a chyle-like fluid when broken (lymphorrhoea). In a later stage still the skin may be coarse and wart-like, and there is a

great

GREAT

tendency for varicose ulcers to form. At the end of a variable time enlargement ceases to take place, and the disease enters a quiescent state: but recrudescences occur at irregular intervals, always ushered in by elephantoid fever. At the end of some years the attacks of fever cease, and the affected part remains permanently swollen. The only difference in the history of the two forms of the disease lies in the fact that the non-filarial form progresses steadily, until either the underlying condition is cured, or in the case of cancer, &c., brings about a fatal issue. The

elephantiasis

ELEPHANTIASIS (Barbadoes leg; Boucnemia)

due to filaria is spread by the agency of mosquitoes, in whose bodies the intermediate stage is passed. The dead mosquito falls upon the water, which thus becomes infected, and hence the ova reach the human stomach. The

young

worm develops, bores through the gastric mucous membrane and finally becomes lodged in the lymphatics; usually of one or other of the extremities. A large number of embryonic filariae are produced. Some remain in the lymphatic spaces and cause lymphatic obstruction, while others enter the blood stream by night (filaria nocturna), or by day (filaria diurna). It is supposed that a mosquito, biting an infected person, itself becomes infected with the blood it abstracts, and that so a new generation is developed.
Treatment for this condition is unsatisfactory. Occasionally the dilated lymph trunks can be found, and an operation per-formed to implant them in some vein (lymphangeioplasty). And in some few other cases artificial lymphatics have been made by introducing sterilized silk

thread

THREAD (0. Eng. praed, literally, that which is twisted, prawan, to twist, to throw, cf. " throwster," a silk-winder, Ger. drehen, to twist, turn, Du. draad, Ger. Draht, thread, wire)

in the subcutaneous tissues of the affected part, and prolonging it into the normal tissues. This operation has been most successful when performed on
elephantoid arms dependent on a

late

LATE

stage of cancerous breast.

Elevation

ELEVATION

of the limb and elastic pressure should always be tried, but often amputation has to be resorted to in the end. The disease is totally different from the so-called elephantiasis graecorum or true leprosy, for which see LEPROSY.
ELEPHANT'S-FOOT, the popular name for the plant Testudinaria elephantipes, a native of the Cape of Good Hope. It takes its name from the large tuberous stem, which grows very slowly but often reaches a considerable size, e.g. more than 3 yds. in circumference with a height of nearly 3 ft. above ground. It is rich in

starch

STARCH

, whence the name Hottentot bread, and is covered on the outside with thick, hard, corky plates. It develops slender, leafy, climbing shoots which die down each season. It is a member of the monocotyledonous order Dioscoreaceae;half of the 17th century, when it became a centre for the trade with south Russia.

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