ELEPHANTIASIS SCROTI.

[ Excerpt from Dr. F. Hollick, "The Origin of Life and the Process of
  Reproduction in Plants and Animals", New York, 1878. Digitized for
  rotten dot com in January 1997. ]

  This terrible disease is fortunately extremely rare in this part of the
world, but still it is necessary to describe it in order to complete our
treatise. It appears in the form of a peculiar swelling of the scrotum,
caused by the infiltration into the integuments of a jelly-like 
albuminous fluid, which accumulates in some cases to a most enormous
extent. The outer surface of the skin appears rough and chapped, or
covered with large brown scales, so that it has somewhat the appearance of
an elephant's foot. Sometimes, but not very frequently, a number of ulcers
are formed, and the chapped places discharge an offensive sanious secretion.

  This disease is chiefly confined to Barbados, though found in other of the 
West India Islands, and also in Egypt, Africa, Greece, and the East Indies.

  The size of the scrotum is sometimes almost past belief, and yet in some
of the very worst cases, the patients enjoy excellent health, without any
disturbances of the functions of other parts of the system, which shows that
the disease is purely local. Mr. Listen removed one of these tumors which
weighted forty pounds, which had been nineteen years growing! M. Delpech
removed one that weighed sixty pounds; and Baron Larrey saw one in Egypt
that weighed over a hundred pounds. Instances have even been known of their
weighing over two hundred pounds, and sometimes the patients have even been
able to sit upon them like a seat. Very often they hang down to the ankles,
and are four or five feet in circumference. There is no cure for this
affection, so far as yet known, and the only remedy is to remove it with the
knife, which has frequently been done with perfect success. Dr. Picton of
New Orleans, removed one of these tumors from the scrotum of a negro, in 
1837, which weighed fifty-three pounds, and had been growing for ten years.
Much larger ones, however, have been removed, and sometimes even without
destroying, or in any way injuring the genital organs, so that the patient
has been as well and perfect afterward as ever he was before. It is,
however, extremely difficult to preserve the genitals, and generally they
have to be removed along with the diseased mass. The great danger is from
loss of blood, and from this many of those operated upon have died. A
Chinese named Hoo Loo came over to London to be operated upon for this 
disease, and Mr. Key removed the tumor, which weighed fifty-six pounds, but
the poor man died fro loss of blood.

  Elephantiasis, though common in some parts of the world, is rare in the
United States. The following case occurred at the Colored Home in this city.

  The patient's name was Isaac Newton, native of Georgia, aged 22. He was
admitted to the hospital March 20, 1866. He had previously enjoyed general
good health, and was in good condition when admitted. About eight years
before, while leaping a fence, he fell astride the rail and bruised the 
scrotum. Some pain and swelling followed, which, however, passed off, and
about three months after it began to feel uncomfortable, and the skin
commenced to thicken, the thickening increased till it extended up the penis,
and reached the prepuce. It then grew rapidly till at last it hung down
near to his ankles. Its appearance when at the hospital is shown in Figure 122.

  At first it pained him very much, but latterly he was only inconvenienced
by its size and weight, which hindered his walking, his general health being
remarkably good -- his weight without the tumor, 159 pounds. The tumor
weighed, when removed, 63-1/2 pounds. His sexual desires were perfect, and he
had occasioned erections and emissions.

  This enormous tumor was successfully removed, in the presence of many noted
surgeons and medical men, May 30, 1866 -- Dr. G. F. Hollick being at that
time house physician. The patient was placed under the influence of ether,
and the operation lasted nearly an hour, including the dressing. It was 
remarkably successful, and on August 6th the wounds were almost entirely
healed, the parts had assumed their natural appearance, and his general health
was much better. He was even gaining flesh.

  April 2, 1867, he was discharged from the hospital, and returned to Georgia.
The parts then presented the appearance shown in Figure 123.


(end excerpt)