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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.
The explanation given of the manner in which elephantoid disease is produced applies to most, if not all, diseases, with one exception, which result from the presence of the parasite in the human body.
The leg below the knee has become enormously deformed by the production of the elephantoid masses; the outer side of the thigh remains healthy, but the skin of the inner side has developed so as to form a very large and pendant lobulated mass. A similar condition has begun to develop in the other leg, which is row about in the condition of the first, as shown in the figure.
Early in this century Rayer described a case of elephantiasis in a boy of seventeen who, after several attacks of erysipelas, showed marked diminution of the elephantoid change; the fact shows the antagonism of the streptococcus erysipelatis to hypertrophic and malignant processes. Acromegaly is a term introduced by Marie, and signifies large extremities.
As an example of the change in the weight of a person after the inception of this disease, we cite a case reported by Griffiths. The patient was a woman of fifty-two who, five years previous, weighed 148 pounds. The elephantoid change was below the waist, yet at the time of report the woman weighed 387 pounds. There was little thickening of the skin.
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