Chapter XI — -177 — Human and Animal Diseases 



in the work of Naeslund. The first or the A form was readily isolated 

 from the mouth. It proved to be the typical A. hovis and could bring 

 about the true actinomycotic infection. The B form was a pathogenic 

 aerobe, considered to be less important than the anaerobe. It was com- 

 monly found in nature, usually producing reddish or yellowish colonies, 

 was acid-fast, and usually formed spores. The properties of these two 

 types, as summarized by Cope, are given in Table 44. Cope (80) re- 

 viewed 1330 cases of actinomycosis. Of these, 56.8 per cent affected 

 the cervicofacial region, 22.3 per cent the abdomen, 14.9 per cent the 

 thorax and 5.9 per cent other sites. 



Lord (265) demonstrated the presence of actinomycetes in sputum 

 and in the contents of 16 carious teeth. Emmons also cultivated organ- 

 isms of the A. hovis type from the oral cavity. Slack (403) presented 

 a detailed discussion of the exogenous vs. endogenous theory of infec- 

 tion in actinomycosis: the first is supported by the fact that awns of 

 grass and grain are frequently observed in actinomycotic lesions; the 

 second is supported by the fact that anaerobic cultures of actinomycetes 

 have been isolated from normal mouth, from tonsils, from carious teeth 

 and from pyonhea pus. The oral cavity was looked upon as the source 

 of infection, possibly accompanied by sensitization. 



Rosebury (368) believed that one and the same organism is the 

 etiologic agent of maxillary actinomycosis in man and of the appendix, 

 pleura, and reproductive organs. Emmons (108) isolated from the 

 tonsils, in pure cultures, two microaerophilic types of actinomyces: one, 

 morphologically and physiologically similar to A. hovis; and the other 

 somewhat different morphologically, but also considered as a strain of 

 A. hovis. Magnusson (283) and Negroni and Bonfiglioli (318) 

 also reported considerable variation in the strains isolated from clinical 

 actinomvcosis. 



True Actinomycosis:— Actinomycosis has often been confused with 

 other infections, as shown by the variety of names applied to it, such 

 as "streptothrichosis," "sporotrichosis," "nocardiosis." This disease af- 

 fects both man and cattle, usually involving the jaw. Because of this, 

 "lumpy jaw," "pig jaw," and "wooden tongue" are terms frequently 

 applied to the disease. It is not contagious, but once acquired is dif- 

 ficult to eradicate. It is characterized by a swollen jaw and a hard 

 board-like induration, accompanied by destruction of the normal tissue 

 and the formation of granulation tissue. The "sulfur granules" present 

 in the pus consist of cellular debris and radially arranged hyphae. The 

 hyphae terminate at the periphery in "clubs" which are composed of 

 eosinophilic material forming a sheath around the h)q3hal tip. This 

 phenomenon has been looked upon by some as characteristic of the 

 particular disease condition. Emmons, however, emphasized that 

 vwhereas other infections also give rise to clubs, certain forms of actino- 



