Identifier: atlasofclinicals00bock (find matches)
Title: Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students
Year: 1908 (1900s)
Authors: Bockenheimer, Ph. (Philipp), b. 1875
Subjects: Surgery, Operative
Publisher: New York : Rebman
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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s. Lastly, the epidermis takespart in the proliferative process, so that the skinbecomes thickened and horny, or eczematous. The affected parts thus become greatly thickened.The thickening may be uniformly distributed, or mayassume a lobulated formation as in elephantiasis ner-vorum. In addition to the proliferation of connectivetissue there is always dilatation of the blood-vesselsand lymphatics. The disease thus appears to origi-nate in lymphatic engorgement, and the proliferationof connective tissue results from lymphatic infiltrationof the tissues. All processes which give rise to lymphatic engorge-ment may, in certain cases, lead to elephantiasis.For this reason, in the endemic form of this elephan-tiasis which occurs especially in Arabia, Egypt, Aus-tralia, and generally in tropical countries, it has beenassumed that the parasites (filaria sanguinis) blockup the lymphatic vessels, causing lymphatic variceswhich rupture and deluge the tissues with lymph, 142 Bockenheinier, Atlas.
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Fig. 7). Elepliaiiliasis penis lympliaiigiectatica. Rebman Company, Neu-Vork. and give rise to hyperplasia of the connective tissue.The lymph vessels may be so dilated that small blad-ders filled with lymph may be visible on the surfaceof the skin. The endemic form generally has an acute onsetwith fever and lymphangitis. After the acute symp-toms have subsided, swelling of the lower extremitiesremains behind. Further attacks follow which causeincreased thickening. Endemic elephantiasis princi-pally affects the scrotum, penis, and female genitals.As in the sporadic form, the thickening is soft at first,but becomes hard later on from diffuse fibromatosis. Sporadic elephantiasis is caused by affections whichgive vise to lymphatic engorgement—chronic oedema,recurrent erysipelas, chronic inflammations such astuberculous and syphilitic, varicose ulcer, phlebitisand thrombosis of veins, and purulent inflammations(especially streptococcus infection). The lower ex-tremities are generally aff

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