170 MEDICAL MYCOLOGY 



Europe), North Africa, and Japan. The lesions are found in regions rich in 

 lymphatics, especially where the skin is liable to be broken by rubbing of the 

 harness, etc. When a wound is infected it fails to heal, appearing brick red 

 and idcerous, producing a serous, yellowish, sanguinolent liquid which forms 

 thin crusts. The ulcer spreads, the margins thicken, become edematous and 

 painful, often with pruritus. After a week to two months it spreads along 

 the lymphatics, producing hard nodules which gradually soften. The skin 

 over them becomes thin and bursts spontaneously, or by trauma, allowing the 

 escape of a purulent yellowish liquid, mixed with tufts of fibrin. These lesions 

 then resemble the initial lesion. Usually these nodes are found along a single 

 lymphatic vessel. When the nodes are close together, they may become con- 

 fliuent. The lymphatic vessels are hard, knotted, warm, and painful. Fre- 

 quently, starting on the lower limbs, they reach the shoulder or hips and 

 produce enormous swellings of the prepectoral, prescapular, or inguinal ganglia. 

 From these points other lymphatic vessels are affected and repeat the process 

 or they may be resorbed or form hard tubes without breaking through to the 

 surface. Tumors may form in the ganglia. These swell to the size of a hen's 

 egg or even of a fist, their surface becomes irregular and is surrounded by 

 a zone of infiltration. The tissue of the tumor is transformed into multiple 

 hollow abcesses which may become confluent or reach the surface of the host 

 separately. They may harden and encyst or be very slowly resorbed. The 

 lymphatic vessels may be gorged with liquid accompanied by great edema. 



Sometimes only the skin is attacked without involvement of the lym- 

 phatics. In this case the lesions resemble those of the nodes but are more 

 superficial. The more superficial ones open after a few days and heal, the 

 deeper ones become abcesses and ulcers which suppurate for several weeks. 

 Very rarely some of the ulcerations bud and promptly form tumors suggestive 

 of papillomata. Occasionally deeper tissues may be involved: periosteum 

 and cartilage (Tokishige), bone (Monod and Velu), synovia and tendons 

 (Pricolo), testicles (Teppaz, Bridre, Negre, and Troutte), and veins, colon, 

 lungs (Velu). They have been reported most frequently on mucous mem- 

 branes (eye, lips, penis, and vulva). 



The lesions are easily reproduced in the horse and the organism has been 

 reported inoculable into testicle of rabbit and into man. 



Although discovered by Rivolta and Micellone in 1883, this organism was 

 not cultivated with comparative ease until recently. In 1895 jMarcone secured 

 gTowth on horse serum to which he added glucose, glycerol, and cane sugar. 

 He observed large spherical cells which either sprouted or elongated. Ob- 

 serving bodies within the elongate cells, he concluded they were internal 

 spores. He was able to reproduce the disease with his cultures. The same 

 year Fei-mi & Aruch isolated a yeast, probably a contaminant, which grcAv 

 luxuriantly on potato. In 1896 Tokishige studied an epizootic on horses and 

 ruminants which clinically appeared to be the same as the European disease. 

 He isolated an organism which greatly resembled that of Marcone but was 

 unable to rejjroduce the disease with it, except in a single case, although he 



