File:Tri-State medical journal and practitioner (1897) (14591702958).jpg

Identifier: tristatemedicalj4189unse (find matches)
Title: Tri-State medical journal and practitioner
Year: 1897 (1890s)
Authors:
Subjects: Medicine
Publisher: St. Louis : (s.n.)
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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idden in the mass; and when the labia are attackedby elephantiasis, the genital cleft is no longer visible, and the urethra Elephantiasis—Ohm ann-Dum esn i l. 211 must be looked for under the enormously enlarged mass. In the case of thedisease affecting the hands or feet, the nails of the fingers and of the toesbecome completely hidden by the mass of hypertrophied tissue around thenail-folds. The characteristics given above are sufficient to lead to a sus-picion of the real trouble, but there are others which will make assurancedoubly sure, if they be observed. When elephantiasis has attained its full proportions, or even sometime before this occurs, the skin is rough, papillomatous, forming in somecases enormous folds, and is more or less pigmented. The openings of thesebaceous ducts gape wide open, permitting of a rather free escape ofsebum. This latter frequently accumulates in thick, elevated crusts, sep-arated from one another as in ichthyosis sebacea, with this exception, that
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Fig. i. Elephantiasis of the Foot in a Man (Caucasian). fungous-like masses also show themselves, as shown in Figure 1. Thisaccumulation of sebum does not always occur, there being in many in-stances a tense, glossy appearance of the integument, in others a ratherrugous surface, the opening of the duct of each sebaceous gland being notonly patulous, but surrounded by a slight elevation. In all cases thelanugo hairs disappear. There appears to be quite an amount of injury tosensation, which in some cases is totally lost. The motor power of a limbwhich is affected is also considerably impaired; so that, altogether, itmay be stated in general terms that a sensible loss of sensory-motor powertakes place in elephantiasis. The first evidence of this trouble which manifests itself is in the formof an attack of erysipelas or of dermatitis. When such a condition occurs 212 Original Articles. in certain individuals, the lymphatic vessels or spaces also become in-volved, and eventually a lymph s

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