340 



HUMAN B0TRY0MYC0SI8 



Microscopic 

 appearanciS) 



Staining 

 reactions 



Degeneration 

 changes 



3. Changes in the blood-vessels, there being a periarteritis and a proliferation 

 of the tunica intinia and tunica media. 



4. Presence of pigment scattered irregularly throughout the tissue in the form 

 of yellow-brown granules lying free, and also phagocyted. Special staining methods 

 showed this to he an iron-containing pigment (Plate XV., fig. 2, C). 



5. The presence of large cells of an epithelioid type lying in necrosed tissue and 

 infiltrating the surrounding fibrous tissue. These epithelioid cells are, for the most 

 part, oval in shape, and contain a nucleus and nucleolus, and some show vacuoles 

 in their cytoplasm. They measure 0'8/i to 12-8/i, and appear to have considerable 

 phagocytic properties, for many of them contain ingested pigment. 



6. Groups of botryomyces lying irregularly scattered throughout the section. 

 These, as already stated, resemble large staphylococci, and occur sometimes singly 

 or more frequently in clumps of coccal masses three to twelve in number. They vary 

 in size from 0'8^ to 128^<. On focussing one of these clumps, one finds that all the 

 coccal masses do not focus iu the same plane, some appearing more superficial than 

 others (Plate XVI., figs. 4 and 5). 



By the ordinary staining methods these coccus-like masses show no differentiated 

 structure. They retain Gram's stain. Owing to their structureless appearance and 

 the fact that their presence in various parts of the section was not associated with 

 any surrounding inflammatory changes, the possibility of their being amyloid or 

 glycogenic in nature indicated that special staining reactions should be employed. 

 The results of these, however, threw no light on their chemical composition for they 

 gave neither the amyloid nor the glycogenic reaction. 



All were acid-fast, and by using special stains a zoogloea-like mass could be seen 

 liolding together, as it were, these coccal-like bodies. 



Several sections had been examined before any idea was obtained as to the 

 probable method of origin of these coccal masses. 



When Muir's method of capsule staining is employed, they take up the fuchsin 

 stain, the methylene blue staining what is evidently a thin rim of protoplasm around 

 each coccus (Plate XVI., fig. 2). Parts of the section, however, when stained by 

 Muir's method, also show two, three, and four coccal discs lying in different focal 

 planes, and clumped together within what appears to be a cell envelope, the whole 

 representing what one may assume to be the botryomycogenous cell (Plate XVI., 

 fig. 1) described by the French observers. These botryomyces, when intra-cellular, 

 appear to multiply within the cell envelope till the latter eventually ruptures 

 allowing escape of the individual cocci, which in turn appear to be taken up by 

 the blood and lymph stream and carried to various parts of the tissues. Sections 

 made from the growth in the scrotum showed these individual coccal masses 

 occupying the lumen of blood-vessels. This method of transmission by means 

 of blood and lymph vessels possibly e.'cplains the presence of some of these 

 botryomyces in apparently healthy fibrous tissue, their presence there, as already 

 stated, not being associated with any inflammatory changes. While, however, 

 these botryomyces are intra-cellular, they apparently bring about degenerative changes 

 in the surrounding tissue which is more or less necrosed. After the cell envelope 

 has ruptured, these coccal masses evidently undergo some form of degeneration 

 of a hyaline type and assume different staining reactions, for, in sections stained by 

 htematein and eosin, the intra-cellular coccal masses take up the nuclear stain of the 

 hiBmatein, while the escaped extra-cellular ones show an affinity for eosin and appear 



