Chapter 16 



MEDICAL MYCOLOGY 



The fungi which are pathogenic to man occupy a position 

 which mav well be designated as a "no man's land" for both the 

 mycologist and the medical practitioner. Even well-trained my- 

 cologists have no first-hand knowledge of humanly pathogenic 

 fungi, and these organisms remain quite unknown to the physician, 

 since they are given little, if any, attention in the curricula of our 

 best medical schools. Lack of proper appreciation of these fungi 

 may also be attributed in part to the fact that the mycologist is 

 quite unacquainted with the clinical aspects or clinical variations 

 and pathological anatomy of the diseases which they produce and 

 that the physician is lost in the maze of controversial taxonomic 

 and cultural difficulties which both he and the mycologist have 

 fostered. Some of these problems have arisen because the patho- 

 genic fungi exhibit so much variation in appearance when in 

 lesions and when grown on various culture media. In addition, 

 some confusion may be attributed to difficulties in interpreting 

 many of the studies and descriptions of the pathogens. Experi- 

 enced, well-trained mycologists with the organisms available for 

 critical study find these taxonomic problems very puzzling and 

 time-consuming. As a consequence a confusion has developed 

 which will depend for clarification upon collaborative studies 

 among clinicians, pathologists, taxonomists, serologists, biochem- 

 ists, and epidemiologists. No single investigator, working inde- 

 pendently, can hope to establish order in a field so chaotic. 

 Thousands of papers on medical mycology, many of them case 

 reports, have been published since 1900. An appreciation of the 

 status and scope of this subject can be gained from Dodge's (1935) 

 Medical Mycology and from the excellent recent summaries by 

 Tate (1929), Ramsbottom (1931), Gregory (1935) and Emmons 

 (1940). The medical practitioner will find the volume by Lewis 



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