Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/208

Dr. Carnegie Brown thought that, although the majority of the Fellows would disagree in toto with the author in most of his conclusions, yet they would all admit that the discussion had prominent advantages. In a science which moved so fast as tropical medicine it was wholesome to have a periodical stocktaking of our knowledge on any given subject, and when one advanced a theory which ran contrary to generally-accepted ideas the review was all the more likely to be of a vigorous and radical character. He thought, too, the author was right in depending largely upon his own experience ; that, after all, was the most valuable quarry from which they could dig out their facts, and most of them would rely on their own experience rather than on that of others. But he certainly could not support him in so completely disregarding recorded experience as to ignore what had been already proved. The author had also, he thought, neglected to emphasise the difference between elephantoid disease and elephantiasis. Dr. Low had somewhat minimised that point too, but still it seemed to be a very important one, for it contained the kernel of the whole matter under discussion. In elephantoid disease — by which, of course, he meant lymph scrotum, lymph varix, chyluria and other similar disorders — it must be held as proved that all the lesions were as certainly due to filarial infection as that malaria was due to infection by the malarial parasite. The author demurred to this on the ground that none of Koch's postulates had been satisfied in the case of elephantiasis and chyluria, but if they asked for Koch's postulates to be confirmed, when metazoal pathogenicity was concerned, they could never hope to have any definite proof of the origin of this class of disease. Chyluria was of three kinds : one, which occurred both at home and in the tropics, was termed idiopathic, and it was so-called because physicians applied the name to a disease when they could not explain its origin ; the second variety