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Ten cases of congenital and hereditary lymphoedema (Milroy’s disease) in a family of 19 members in 5 generations have been described. The literature is briefly reviewed.

Milroy's disease is a congenital familial type of lymphedema which generally involves only the lower extremities up to the inguinal ligament. Letessier in 1865 was the first to report the condition in an account of 4 cases of lymphedema in a single German family. Milroy in 1892 reported 22 cases of an “undescribed variety of hereditary edema” in 6 generations of a single family. In 1899 Meige described an additional 8 cases in a French family. In these 8 cases, however, the onset of edema occurred at puberty rather than at birth. In spite of a considerable amount of literature concerning the disease since that time, we have been unable to find any published report of pleural effusion in association with chronic hereditary lymphedema. Case Reports Case I: E. F., a 44-year-old white male, had suffered from edema of both legs since birth, as had his mother and one sister (Case II). The mother died in 1923 at the age of thirty-three from “septic poisoning.” No previous cases of lymphedema were known to have o...

During the past four years, five patients with Milroy's disease, or chronic hereditary lymphedema, have been treated by us (figure). These were found in two generations of a family. Four additional cases in other members of the family were described to us, but we did not see them. Because of the obscure nature and relative rarity of this condition and because of our experiences with various forms of treatment, these cases are being presented. In searching through the English literature published since 1892, when this condition was first described, we have been able to find approximately 30 similar families, comprising approximately 125 cases. A number of theories concerning the cause of the disease have been suggested by various authors, but no definite cause has been proved. We have attempted a thorough investigation of each of these cases along the conventional lines and along lines suggested by previous authors. No constructive

The condition variously known as Milroy's disease, hereditary edema, trophedema and congenital elephantiasis with a familial or hereditary incidence is so rare that another instance of it deserves to be recorded. REPORT OF A CASE History .—Robert G., born on Oct. 10, 1916, was admitted to the hospital on Oct. 7, 1929; the complaint was swelling of the legs since birth and swelling of the scrotum for the past two months. The maternal grandmother and the mother had had enlargement of the legs since childhood. The mother died of influenza in 1918, and the complete family history was unobtainable. The maternal family came from southern France, in the high Pyrenees Mountains. The patient had a brother who was normal. Birth occurred at full term and delivery was normal. It was said that the child would never walk. The patient had mumps at 10 years of age. His school record was

A case of hereditary edema of the legs with other congenital anomalies recently came under my observation. Hereditary edema of the legs being rare, its combination with other congenital anomalies warrants reporting this case as one of unusual interest. REPORT OF A CASE L. L., a white woman aged 28, was first seen at the Northwestern University Medical School on April 15, 1939. She stated that her limbs had been enlarged since infancy and that her mother and an aunt had the same condition. The enlargement appeared soon after her birth and gradually progressed during her growth and development. She had experienced no discomfort until about one and one-half years before her appearance at the clinic, when painful swelling of both feet developed, more evident during the afternoon and evening. Rest at night, however, did not materially reduce the swelling or relieve the pain. Properly fitted shoes were prescribed and

Idiopathic hereditary lymphedema may have its onset either at birth or at any time between childhood and early adulthood. Certain authors insist that the eponym "Milroy's disease" should be restricted to those cases that have a congenital origin, 1 whereas others see no need for undue emphasis on the age at which the edema appears, inasmuch as the clinical picture is otherwise essentially identical. 2 Milroy himself, in a 35-year follow-up report of the family he originally described, indicated that the age at which edema appears varies. 3 The prevailing opinion appears to be well summarized as follows 4 : "Primary lymphoedema is occasionally congenital, but more often it starts in childhood or adolescence and is then called lymphoedema praecox. In its most severe form the disease may produce deformities like those of tropical elephantiasis, and the term elephantiasis nostras (meaning 'ofour country') is then sometimes used." Families have been described

The occurrence of familial hereditary edema, also known as Milroy's disease, hereditary trophedema and hereditary or congenital elephantiasis, is rare, particularly when a continued familial incidence can be demonstrated. Search of the literature reveals that fewer than fifty families with this hereditary syndrome have been reported. The following case is presented because such reports are rare and because of the studies, manifestations and improvement on treatment. REPORT OF CASE A. W. S., a white man, aged 25, unmarried, a selectee in the United States Army, was admitted to the Station Hospital, Camp Callan, California, Aug. 4, 1941 because of pain, swelling and mottled redness of the right foot. In civilian life he had been a painter. His home was in the Middle West. Since his induction in the army seven weeks prior to entering the hospital, he had been engaged in the usual training and drilling on the camp grounds.

The paucity of knowledge regarding the pathogenesis of hereditary edema of the extremities justifies the description of a characteristic case which we have had the opportunity to observe for several years and from which sections of skin have been examined on two occasions. The earliest descriptions of this peculiar disease were published almost simultaneously by Nonne 1 and by Milroy. 2 Subsequently several additional cases have been described and various theories advanced concerning the etiology of the condition. The characteristics of the disease may be summarized as follows: The condition is always hereditary. Only the lower extremities are affected. There is no evidence of local obstruction or of the usual constitutional causes of edema. The edema is persistent. The state of general health is excellent and longevity is the rule. As none of the recorded cases have come to autopsy and as there is no report regarding material obtained at

To the Editor:— Your editorial 1 gave an interesting account of Dr. Milroy of Omaha, who is eponymously memorialized in hereditary lymphedema. Dr. Thomas Findley, professor of medicine emeritus at the Medical College of Georgia, has told me that Milroy was his family's physician when he was growing up in Omaha. You might have mentioned that in 1928 2 Milroy published a followup on the family with lymphedema (which was not Dr. Findley's), which was first reported in 1892. The propositus was at that time still alive in his late 60's and was active as a missionary in Burma. Affected members of the family also included a clergyman in Florida (who had died before 1928), a congressman, a US senator, and a Chicago physician (also deceased), who had served as a surgeon in the US Navy in the Civil War. Surely affected members of that family are still living. The