登陆注册
4281000000371

第371章

Lymphedema, or elephantiasis arabum, is a condition in which, in the substance of a limb or a part, there is diffused dilatation of the lymphatics, with lymphostasis. Such a condition results when there is obstruction of so large a number of the ducts converging to the root of the extremity or part that but little relief through collateral trunks is possible. The affected part becomes swollen and hardened, and sometimes attains an enormous size. It is neither reducible by position nor pressure. There is a corresponding dilatation and multiplication of the blood-vessels with the connective-tissue hypertrophy. The muscles waste, the skin becomes coarse and hypertrophied. The swollen limb presents immense lobulated masses, heaped up at different parts, separated from one another by deep sulci, which are especially marked at the flexures of the joints. Although elephantiasis is met with in all climates, it is more common in the tropics, and its occurrence has been repeatedly demonstrated in these localities to be dependent on the presence in the lymphatics of the filaria sanguinis hominis. The accompanying illustration shows the condition of the limb of a girl of twenty-one, the subject of lymphedema, five years after the inception of the disease. The changes in the limb were as yet moderate. The photograph from which the cut was made was taken in 1875 At the present time (seventeen years later) the case presents the typical condition of the worst form of elephantiasis. Repeated attacks of lymphangitis have occurred during this period, each producing an aggravation of the previous condition. 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. Figure 273 represents this disease in its most aggravated form, a condition rarely observed in this country. 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 148pounds. 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. The circumference of the calf was 28inches; of the thigh, 38 inches; and of the abdomen, 80 inches;while that of the arm was only 15 inches.

The condition commonly known as "Barbadoes leg" is a form of elephantiasis deriving its name from its relative frequency in Barbadoes.

Figure 275 represents a well-known exhibitionist who, from all appearances, is suffering from an elephantoid hypertrophy of the lower extremities, due to a lymphedema. Quite a number of similar exhibitionists have been shown in recent years, the most celebrated of whom was Falmy Mills, one of whose feet alone was extensively involved, and was perhaps the largest foot ever seen.

Elephantiasis seldom attacks the upper extremities. Of the older cases Rayer reports four collected by Alard. In one case the hard and permanent swelling of the arm occurred after the application of a blister; in another the arm increased so that it weighed more than 200 Genoese pounds, 40 of which consisted of serum. The swellings of the arm and forearm resembled a distended bladder.

The arteries, veins, and nerves had not undergone any alteration, but the lymphatics were very much dilated and loaded with lymph.

The third case was from Fabricius Hildanus, and the fourth from Hendy. Figure 276 represents a remarkable elephantoid change in the hand of an elderly German woman. Unfortunately there is no medical description of the case on record, but the photograph is deemed worthy of reproduction.

Terry describes a French mulatto girl of eleven whose left hand was enormously increased in weight and consistency, the chief enlargement being in the middle finger, which was 6 1/2 inches long, and 5 1/2 inches about the nail, and 8 1/2 around the base of the finger. The index finger was two inches thick and four inches long, twisted and drawn, while the other fingers were dwarfed. The elephantiasis in this case slowly and gradually increased in size until the hand weighed 3 1/2 pounds. The skin of the affected finger, contrary to the general appearance of a part affected with elephantiasis, was of normal color, smooth, shiny, showed no sensibility, and the muscles had undergone fatty degeneration. It was successfully amputated in August, 1894. The accompanying illustration shows a dorsal view of the affected hand.

Magalhaes of Rio Janeiro reports a very interesting case of elephantiasis of the scalp, representing dermatolysis, in which the fold of hypertrophied skin fell over the face like the hide of an elephant, somewhat similar in appearance to the "elephant-man." Figure 279 represents a somewhat similar hypertrophic condition of the scalp and face reported in the Photographic Review of Medicine and Surgery, 1870.

Elephantiasis of the face sometimes only attacks it on one side.

同类推荐
  • 英云梦传

    英云梦传

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
  • 大乘阿毗达磨集论

    大乘阿毗达磨集论

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
  • 史氏菊谱

    史氏菊谱

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
  • THE PROFESSOR

    THE PROFESSOR

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
  • 增一阿含经

    增一阿含经

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
热门推荐
  • 潜书

    潜书

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
  • 白话夜雨秋灯录3

    白话夜雨秋灯录3

    本书是《夜雨秋灯录》与《夜雨秋灯续录》的合集本。本书展示了一个不一样的中国古代世界,充满了想象力。本书中的故事情节曲折,文笔丽而不绮。
  • 断天大陆

    断天大陆

    在一个古老的大陆上,战争不断,硝烟狂飞,亿万大军攻进龙族……而龙族守护神——轩玄魔,却奇异的转世在了一个人族小子身上,万年光阴,沧海桑田,仍是亿万大军,强者云集,势力林立,再次踏上征龙旅程……而那个人类小子,也被卷入了这场大战中……
  • 红颜祸乱:艳妾夺心

    红颜祸乱:艳妾夺心

    她是奸臣之女,她被充为官妓。如果不是遇到他,她的一生将在屈辱卖笑中度过。他为她赎身,他迎她过门。本来,她该感恩戴德,感激涕零……可,偶然得知,他竟是她的弑父仇人!那么,于情于理,她该何去何从……
  • 盛世情侠:草莽王侯

    盛世情侠:草莽王侯

    一个隐没于草莽间的北周皇室遗脉,一段旷世爱情传奇,一场鲜血染红的爱情战争,一段称霸江湖的铁血故事。兄弟相残,血溅五步;权力倾轧,彼此利用;热血男儿,肝胆相照;但为红颜,冲冠一怒……他弑父杀兄,屠戮江湖,结交邪佞,阴谋复辟;他一言九鼎,豪气冲天;他有无数红颜知己,却将一腔热血付给了一个女人。是正?是邪?
  • 农家妾

    农家妾

    她是田间雀,他是折翅雁,雁徙千里路,雀栖方寸间,雁落雀巢,其志犹存耶?雀随雁去,其翅何撑天?游鱼尚有化龙日,安知燕雀之翼难遮天?
  • 义演法师西斋

    义演法师西斋

    本书为公版书,为不受著作权法限制的作家、艺术家及其它人士发布的作品,供广大读者阅读交流。汇聚授权电子版权。
  • 冒牌道士

    冒牌道士

    我新租了一间公寓,可是半夜十二点钟刚过,总有人来敲门。他们都找一个叫“江九真”的人。江九真我不认识,更不知道在哪。可总这么敲门,我也受不了呀!而且最让我觉得怪异、惊悚的是,他们居然不是......
  • 绝色丹药师:惊世毒妻

    绝色丹药师:惊世毒妻

    她是21世纪神秘武馆少馆主,隐世神医之徒,一朝穿越,变成了帝府人人唾弃的废物大小姐。焰鼎在手,丹药我有;魔笛在手,众兽俯首!双系元素很厉害?四系特殊灵力亮瞎你的钛合金狗眼!你想玩宅斗?想要我随时奉陪?没问题!你在阵法遛弯,我在学校修炼,两不误!听说你家大小姐心狠手辣,人见人怕?那这个傲娇呆萌求朋友的少女是谁?咱家招贼了?无所谓,反正我那个两辈子的好闺蜜把拿的钱都还我了,只是没有你们的份!身旁桃花朵朵开,美男在侧任她选......唉,说好的任她选呢?为什么桃花全都被扇飞了。“不要再缠着我了!”某女霍霍磨牙。某妖孽男挑眉:“不让我缠你?那我压你如何?”“......”欲知后事如何,请听下回分解。
  • 三十八岁时的爱情

    三十八岁时的爱情

    性情才女以中年的眼睛看人世冷暖,宇宙星辰,特别阐释、思索中年的情与爱,乐与愁,三十八岁的爱情多一份深沉和凝重,多了一份淡定和恬淡,且看她细细道来。