enlarged and painful. In severe cases the symptoms merge into those of
septicaemia. When the deep lymph vessels alone are involved, the
superficial red lines are absent, but the limb becomes greatly swollen
and pits on pressure.

In cases of extensive lymphangitis, especially when there are repeated
attacks, the vessels are obliterated by the formation of new connective
tissue and a persistent solid oedema results, culminating in one form of
elephantiasis.

_Treatment._--The primary source of infection is dealt with on the usual
lines. If the lymphangitis affects an extremity, Bier's elastic bandage
is applied, and if suppuration occurs, the pus is let out through one or
more small incisions; in other parts of the body Klapp's suction bells
are employed. An autogenous vaccine may be prepared and injected. When
the condition has subsided, the limb is massaged and evenly bandaged to
promote the disappearance of oedema.

_Tuberculous Lymphangitis._--Although lymph vessels play an important
role in the spread of tuberculosis, the clinical recognition of the
disease in them is exceptional. The infection spreads upwards along the
superficial lymphatics, which become nodularly thickened; at one or more
points, larger, peri-lymphangitic nodules may form and break down into
abscesses and ulcers; the nearest group of glands become infected at an
early stage. When the disease is widely distributed throughout the
lymphatics of the limb, it becomes swollen and hard--a condition
illustrated by lupus elephantiasis.

_Syphilitic lymphangitis_ is observed in cases of primary syphilis, in
which the vessels of the dorsum of the penis can be felt as indurated
cords.

In addition to acting as channels for the conveyance of bacterial
infection, _lymph vessels frequently convey the cells of malignant
tumours_, and especially cancer, from the seat of the primary disease to
the nearest lymph glands, and they may themselves become the seat of
cancerous growth forming nodular cords. The permeation of cancer by way
of the lymphatics, described by Sampson Handley, has already been
referred to.

#Lymphangiectasis# is a dilated or varicose condition of lymph vessels.
It is met with as a congenital affection in the tongue and lips, or it
may be acquired as the result of any condition which is attended with
extensive obliteration or blocking of the main lymph trunks. An
interesting type of lymphangiectasis is that which results from the
presenc