File:An American text-book of genito-urinary diseases, syphilis and diseases of the skin (1898) (14596245347).jpg

Identifier: americantextbook00bang (find matches)
Title: An American text-book of genito-urinary diseases, syphilis and diseases of the skin
Year: 1898 (1890s)
Authors: Bangs, Lemuel Bolton, 1842-1914 Hardaway, W. A. (William Augustus), 1850-1923
Subjects: Urogenital System Urination Disorders Syphilis Skin Diseases
Publisher: Philadelphia, W. B. Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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y mild, with no fever.The rapidity of the enlargement of the limb depends very much on theintensity and frequency of the febrile attacks. 972 H YPER TR OP HIES. After the first attack the limb appears as it does in a case of dropsy, andthere is pitting on pressure; but after several attacks the tissues becomedense and hard and unyielding, and the limb is permanently and uniformlyswollen. The enlargement rarely reaches above the knee. The skin may have a shiny, eczematous appearance or be formed intofolds and ridges looking something like ichthyosis and having a rugose ap-pearance (Fig. 244). In such cases the papillae are much increased in size. The enlargement increases until the limb is of an enormous size and itsnatural shape is obliterated, the integument being formed into large folds, sothat the whole limb has an appearance not unlike an elephants leg; At theankle especially the furrow is very deep, and the resulting fold often hidesthe greater portion of the foot (see Fig. 245).
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Fig. 245.—A Ichthyotic form of elephantiasis: B, elephantiasis. When the leg has become greatly swollen the natural furrows and foldsgreatly increase, and where the two surfaces of skin come together an offen-sive ichorous fluid exudes, consisting of broken-down epithelium, sebum,and sweat. In the form resembling ichthyosis the thickened epidermis is dirty-lookingand often of a deep-brown color. Some forms are subject to frequent attacksof eczema, accompanied by much itching, and the skin is smooth and shiny.Occasionally deep, foul varicose ulcers occur, discharging an ichorous pus. In many cases the general health does not suffer, and there is no pain or ELEPHANTIASIS. 973 other disturbance of sensation during the interval between the febrile attacks.The patient eats and sleeps well, and all his functions are normally per-formed, and, if it were not for the discomfort caused by the size and weightof limb, he would be to all intents and purposes well. When the febrileattacks are fre

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