The Deep Mycoses \ Essentially or Potentially Systemic) 203 



liicle. Therapy is begun with L5 drops, well diluted, given three times dail) 

 before meals. The dose is increased 5 drops daily until there are symptoms 

 of intolerance. The dosage just below that which produces symptoms should 

 he maintained lor several weeks or months, according to the response <>l 

 the patient. Tincture ol iodine is sometimes given for a change. Ethyl iodide 

 In inhalation has also been used. 



(4) Specific vaccinotherapy.— -This was advocated by Stober, who has 

 obtained clinical improvement with its use. Martin and his collaborators 

 believe that desensitization should be practiced in all patients found sensi- 

 tive to the fungus on testing, before any other therapy, such as administra- 

 tion of iodides, is instituted. 



(5) Colloidal copper.— Jacobson recommended intramuscular injections. 



(6) Antiserum.— Martin reported favorably on the use of anti-Blastomyces 

 rabbit serum kept for diagnostic purposes. 



(7) Supportive measures— Thev are of vital necessity, particularly in 

 systemic involvement. Rest, sunshine and a nutritions diet may be helpful. 



BIBLIOGRAPHY 



Benham, R. W.: Fungi of blastomycosis and coccidioidal granuloma, Arch. Dermat. & Syph. 



30:385, 1934. 

 Bergstrom 3 Y. \\\; Nugent, C, and Snider, M. C: Blastomycosis: Report of case with 



involvement of skin and bones, Arch. Dermat. & Syph. 36:70, 1937. 

 Brody, M.: Blastomycosis North American type: Proved case from European continent, Arch. 



Dermat. & Syph. 56:529, 1947. 

 DeMonbreun, W. A.: Experimental chronic cutaneous blastomycosis in monkeys: Study of 



etiologic agent, Arch. Dermat. & Syph. 31:831, 1935. 

 Foshay, L., and Madden, A. G.: The dog as natural host for Blastomyces dermatitidis. Am. 



J. Trop. Med. 22:565, 1942. 

 Gilchkist, T. C.: Case of blastomycetic dermatitis in man, Johns Hopkins Hosp. Rep. 1:269, 



1896. 

 Martin, D. S.: Practical application of some immunologic principles to diagnosis and treat- 

 ment of certain fungus infections, ]. Invest. Dermat. 4:471, 1941. 

 Montgomery, F. H.: Brief summary of clinical, pathologic, and bacteriologic features of 



cutaneous blastomycosis (blastomycetic dermatitis of Gilchrist), from observations of James 



Nevins Hyde and the writer, with illustrations from 13 cases, J. A. M. A. 38:1486, 1902. 



, and Ormsby, O. S.: Systemic blastomycosis, Arch. Int. Med. 2:1, 1908. 



Ormsby, O. S., and Miller, H. M.: Systemic blastomycosis, J. Cutan. Dis. 21:121, 1903. 

 Hixiohd, E.: Two cases of protozoan (coccidioidal) infection of skin and other organs, Johns 



Hopkins Hosp. Rep. 1:209, 1896. 

 Smith, L. M.: Blastomycosis and blastoim cosis-like infections, J. A. M. A. 116:200, 1941. 

 Spring, D.: Comparison of seven strains of organisms causing blastomycosis in man, J. Infect. 



Dis. 44:169, 1929. 

 Stober, A. M.: Systemic blastomycosis, Arch. Int. Med. 13:510, 1914. 



6. HISTOPLASMOSIS 



This is a rare disease essentially affecting the reticuloendothelial cells 

 and when well developed is almost always fatal. This active type is rarely 

 diagnosed ante mortem. 



