Under this common name two entirely different diseases are comprehended : E. Arabum, elephant leg, or Barbadoes leg; and E. Groecorum, elephant skin, or tubercular elephantiasis. I. Ele-pliantiasis Arabum was described by Rhazes in the 9th century; it prevails extensively in Barbadoes, and is common in Demerara, Cayenne, and Brazil, in the S. W. part of the island of Ceylon, and on the Malabar coast in India; it is sometimes found in Castile and the Asturias in Spain, and occasional sporadic cases are met with throughout Europe and America. Notwithstanding its name, the disease is not confined to the leg, but may attack almost any part of the body. The attack is ushered in by marked rigor, headache, pain in the back and limbs, followed by heat of the skin, alternating with profuse perspiration, and attended with burning thirst; at the same time some part of the body becomes red and swollen, hot and painful, particularly along the tract of the lymphatic vessels. In a few days the symptoms, both general and local, subside, with the exception that the affected part remains more or less swollen.
At irregular intervals similar paroxysms recur, the affected part being each time left more swollen and indurated; as the enlargement increases, the skin often becomes rough, covered with scales, and fissured. The disease is usually confined to one part of the body, though occasionally both legs are affected. The affected parts often attain an enormous size. The causes of Barbadoes leg are not understood; its occurrence in particular districts shows that local causes have something to do with its production. In the West Indies the negroes, and in Ceylon the native race, are affected much more frequently than the whites; and of the whites, the Creoles, those born in the country, are more liable than recent immigrants. In the treatment of the disease in the earlier stages, emollient applications, the warm bath, and bloodletting have been advised. Some physicians think benefit has been derived from the exhibition of mercury. When the disease has already made considerable progress, rest in a position which favors the return of the blood from the limb, and compression by means of proper bandaging, are the means most to be relied upon.
II. Elephantiasis Groecorum, tubercular elephantiasis, appears to have been the disease which during the middle ages was known as leprosy; it is most frequently met with in the West India islands, and in other tropical regions, while it also prevails extensively in certain parts of Norway, where it is known as spedalsked. The disease ordinarily commences by the appearance of dusky shining spots upon the skin, slightly swollen, and more or less insensible. After a variable period, which may extend to months, and even years, these spots are succeeded by tubercles or small tumors, soft, reddish, or livid in color, and varying in size from a pea to an English walnut. These tubercles developed upon the face deform it excessively, giving it often a fancied resemblance to the head of the lion, whence one of the names by which the disease is known (leontiasis) is derived. As the disease advances, the tubercles become inflamed and ulcerated; the ulcers exude a sanious fluid, and this concretes into thick crusts; the bones become softened and altered in form. In the progress of the disease the gastro-intestinal mucous membrane becomes involved, and tubercles make their appearance in the pharynx; the sense of smell is lost, sight is weakened, and the touch blunted.
In this wretched condition the patient may continue to exist a long time, unless cut off, as is commonly the case, by some intercurrent disease. In a second form of the disease, E. ancesthetica, patches of an irregular shape, sometimes slightly elevated above the surface, appear upon the extremities, of a tawny color; in whites they are lighter than the rest of the surface; in the negro they are dry, shining, rough, denuded of hair, and insensible. The hands and feet, and afterward the limbs, generally become swollen, stiff, and numb; ulcers form on the metacarpal and metatarsal articulations; these enlarge, penetrate the joint, and finally amputate the toes and fingers. As the disease advances, the pulse becomes slow and the bowels constipated; sometimes it is complicated with the tubercles of the other variety; in other cases the lobes of the ears, the wings of the nose, and the lips become thick, hard, swollen, and ulcerated. The patient is listless, and his intellect enfeebled, and in this condition he may live many years. The causes of tubercular elephantiasis are unknown; it appears to be hereditary; but the once prevalent opinion of its contagiousness is not found to agree with recent observations.
Of its proper treatment little is known. .