Contributions to the Physiology of the Stomach

Abstract

Our patient showed improvement soon after antisyphilitic treatment was instituted, and three months later the thickness of the skin was greatly reduced and soft, so that the testes were now easily palpated. Six months after treatment was started, the circumference of the scrotum was reduced from 18 inches to 11 inches.The hypertrophy, coming on gradually without chills and fever or without any attacks of pain, erythema or erysipelas, which are almost constant findings in the streptococcic type, are the chief points against this case being of that etiology. Likewise the negative cultures and absence of bacteria in the sections do not favor streptococcus as the etiologic agent. The history of syphilis, the positive Wassermann reaction on several occasions and the rapid involution under antisyphilitic treatment point to syphilis as the chief if not the only etiologic agent in this case. CONCLUSIONS 1. Although most cases of sporadic elephantiasis are streptococcic in origin, undoubtedly a few cases are syphilitic.2. Arteritis and phlebitis probably play an important part in the stasis and subsequent hypertrophy.3. Improvement, if not complete involution, can be obtained by antisyphilitic treatment in some cases. ABSTRACT OF DISCUSSIONDr. John H. Stokes, Philadelphia : My impression is that the cause of scrotal elephantiasis may lie back of the scrotum and be ascribable, perhaps, to gummatous changes in the lymph nodes in some cases. In tuberculous elephantiasis of the vulva and of the leg, tuberculous obliteration of the lymph nodes may be responsible for much of the picture pro¬ duced by lymphatic stasis, plus, in some cases, intercurrent streptococcal infection.