There are two varieties. One is a thread-like worm with tapering, blunt ends, appearing in the blood at night, hence called =nocturna=, while the other is of slightly different form, appearing in the blood only by day and is called =diurna=. The mosquito is the communicating host of the parasite. During the night, or should the patient sleep during the day, the =nocturna= appears in the peripheral circulation, while during the other interval they are probably in the other vessels, particularly the lungs. After the mosquito has taken blood from an affected patient it requires from six to seven days for the metamorphosis of the minute filaria which are then lodged in the probosis of the mosquito and introduced into the blood of the next victim. The adult parasite is from three to four inches long and the thickness of a coarse hair, with clear sexual distinction. =Pathologically= there are no distinct lesions, as the parent worm must establish one. Lymphatic engorgement may result from plugging of the thoracic duct or of a large lymphatic with consequent engorgement which may develop symptoms in the inguinal glands, pelvic and lumbar lymphatic trunks. As these varicosities develop rupture may occur; if into the genito-urinary tract chyluria or chylocele may result, or if in the abdominal cavity chylous ascites. Lymphangitis follows a lymph stasis, which later results in =elephantiasis=. (Barbadoes leg.) =Symptoms.=—Elephantiasis affects the legs, but the arms rarely; the labia of the female and scrotum of the male; occasionally the breasts and other parts of the body. Fever is present on account of the lymphangitis, accompanied by rigors and delirium and there is marked local inflammation. The attack terminates in a pronounced sweat. In deeper parts there is deep seated pain and signs of sepsis, while abscesses may develop over the inflamed area. The varicose inguinal glands are doughy, soft and painless, with both sides affected alike. The scrotum is affected by the extension, and at times the testes. =Treatment= is surgical, as the tumors must be removed. Unless the female worm is also removed this is, however, only palliative. Methylene blue is said to be destructive to the filaria and it is practically harmless to the human body. The only treatment is one that will aid in building up the general health. HEMORRHAGES Nasal Hemorrhage (Nose bleed; Epistaxis) =Osteopathic Etiology= and =Pathology=.—Traumatism, such as picking the nose, blows, and surgical operations; straining when coughing; nasal tumors and ulcerations; lesions of the atlas, or any lesion of the upper cervical vertebræ, that would interfere with the vasomotor distribution to the nose and cause local congestion or weakness of the blood vessels; obstructions to the general circulation; irregularities or suppression of the menstrual flow may result in nose bleed, as a vicarious menstruation; suppression of a habitual hemorrhoidal discharge.