The treatment of the condition is such as would be advisable for ordinary lymphangitis—rest in bed, elevation of the part, laxatives and local applications.
Lymph Scrotum
This condition is apt to set in with fever. The scrotal tissues are somewhat tense and reddened and may show numerous lymphatic varices which when pricked with a needle, give exit to lymph which may or may not contain filarial embryos. The lymph continues to exude for a long time. Erysipelatous manifestations are not uncommon. With recurring attacks the scrotal tissues become more and more hypertrophied and may go on to elephantiasis of the scrotum.
Ordinarily local applications with suspension of the scrotum is the proper treatment. Should the thickening increase to a great extent the blubbery tissues may be excised, care being exercised to avoid the testicles and to bring together sound tissue for the enclosing flaps. These wounds usually heal readily, although there may be delay in healing from the outpouring of lymph in cases where the flaps include diseased tissue.
Varicose Groin Glands
Swellings which come on rather slowly and insidiously may involve the inguinal or femoral groups of glands of one or both sides. The epitrochlear glands may also be involved. The skin over the enlarged, rather doughy glands can be freely moved but the glands themselves are bound down to the deeper tissues. Elephantoid fever may set in associated with local manifestations of pain and redness.
If such glands are punctured with a hypodermic needle lymph, which may contain embryos, exudes. This test together with their slow disappearance on lying down and slow return on assuming the upright position should differentiate hernia. When the contents of a hernial sac are omental there is some difficulty in diagnosis. As a rule it is not advisable to interfere surgically in this filarial condition.
Fig. 99.—Varicose groin glands and elephantiasis of scrotum and penis. (From Ruge and zur Verth.)
Filarial Abscesses