Fig. 112—Tsetse-fly. (After Manson.)
This species, Filaria bancrofti, is not only very widely distributed, but in regions such as some of the South Sea Islands a very large per cent of the natives have the filariæ present in their blood. When these parasites are withdrawn from the circulation and placed on a slide for study they are seen to be minute transparent, colorless, snake-like organisms inclosed in a very delicate sack or sheath. They are but a little more than one-hundredth of an inch long and about as big around as a red blood-corpuscle. These are the larval forms of the parasite and have been called by Le Dantec the micro-filaria.
If blood of the patient drawn from the skin, is examined during the day few if any of these parasites are found, but if it is examined between five or six o'clock in the evening and eight or nine o'clock the next morning they may be found in numbers. During the daytime they have retired from the peripheral circulation to the larger arteries and to the lungs, where they may be found in great numbers.
This night-swarming to the peripheral circulation has been found to be a remarkable adaptation in the life-history of the parasite, for it has been demonstrated that in order to go on with its development these larval forms must be taken into the alimentary canal of the mosquito. Most of the mosquitoes in which the development takes place are night-feeders, so that the parasites are sucked up with the blood of the victim. Once inside the stomach they soon free themselves from the inclosing sheath and make their way through the walls of the stomach and enter the muscular tissue, particularly the thoracic muscles. Here they undergo a metamorphosis and increase enormously in size, some attaining one-sixteenth of an inch in length.
After sixteen to twenty days they leave these muscles and make their way to other parts of the body. A few may be found in different parts of the abdomen, but most of them make their way forward into the head of the mosquito and coil themselves up close to the base of the proboscis, finally finding their way down into the proboscis inside the labium. Here they lie until an opportunity offers for them to escape to the warm blood of a vertebrate. They probably pass through the thin membrane connecting the labella with the proboscis and there find their way into the wound made by the puncture when the insect bites. Whether these parasites can gain an entrance into the circulatory system in any other way is not known. It has been suggested that the mosquitoes dying and disintegrating on the surface of water may liberate the filariæ which may later find their way into the system of the vertebrate host when the water is used for drinking, but most of the investigations made so far seem to indicate that they make their way directly from the proboscis into the new host.
Soon after entering the circulatory system of the human host the parasites make their way into the lymphatics where they attain sexual maturity, and in due time new generations of the larval filariæ or microfilariæ are poured into the lymph, and finally into the definite blood-vessels, ready to be sucked up by the next mosquito that feeds on the patient.
In most cases of infection the presence of these filariæ in the blood seems to cause no inconvenience to the host. They are probably never injurious in the larval stage, that is, in the stage in which they are found in the peripheral circulation.
In many cases, however, the presence of the sexual forms in the lymphatics may cause serious complications. The most common of these is that hideous and loathsome disease known as elephantiasis in which certain parts of the patient becomes greatly swollen and distorted. An arm or a leg may become swollen to several times its natural size, or other parts of the body may be seriously affected.
In some of the South Sea Islands 30% to 40% of the natives are afflicted in this way, some only slightly others seriously. There is little or no pain, but in severe cases the distorted parts often render the patient entirely helpless.