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The affection is frequently bilateral, and may be associated with lymph scrotum, with elephantiasis, and with chyluria. The diagnosis is to be made from such other swellings in the groin as hernia, lipoma, or cystic pouching of the great saphenous vein. It is confirmed by finding the recently dead or dying worms in the inflamed lymph glands. Treatment.
The true pathology of the elephantoid diseases may thus be briefly summarized: A parent filaria in a distant lymphatic prematurely expels her ova; these act as emboli to the nearest lymphatic glands, whence ensues stasis of lymph, regurgitation of lymph, and partial compensation by anastomoses of lymphatic vessels; this brings about hypertrophy of tissues, and may go on to lymphorrhoea or chyluria, according to the site of the obstructed lymphatics.
White urine, commonly known as chyluria, is frequently seen, and sometimes results from purulent cystitis. Though containing sediment, the urine looks as if full of milk. A case of this kind was seen in 1895 at the Jefferson Medical College Hospital, Philadelphia, in which the chyluria was due to a communication between the bladder and the thoracic duct.
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