Lymphedema.
When compression, position, massage, and such measures fail the only other resort is amputation.
LYMPHANGIECTASIS AND ELEPHANTIASIS.
These terms refer to dilatation of the lymphatics, with a minimum of actual obstruction, often as a sequence of some previous lesion which has disappeared. In some of its expressions the condition is a manifestation of a widespread general disease or a parasitic infection. This is particularly true in those forms due to the presence of filariæ in the blood, in which it is not a question of the obstruction of one of a series of vessels, but plugging of a number of them by the adult worms, which reside especially in the larger lymph and chyle passages, sometimes even causing the appearance of chyle in the urine.
Elephantiasis is an expressive term given to any enormous enlargement of a part of the body, due to a combination of causes, of which lymphatic dilatation and obstruction together constitute the most important feature. The so-called congenital forms may have to do with congenital deviations from the normal standard, but should be differentiated from instances of gigantism, which have already been alluded to in Chapter I, into whose etiology different factors probably enter.
Fig. 185
Fig. 186
Elephantiasis of leg, scrotum, and penis.