iriSCELLANEOrS NOTES 365 



to me that their habitat might not be the blood but the skin, from which they may 



have been washed out by the first drop of blood. I had no means of telling which was the 



first film taken, but I noted that Horrocks and Howell, on several occasions, found the 



bodies in one slide out of several examined. On the other hand, this was by no means their 



invariable experience, while they once recovered the bodies from broth into which a piece 



of the liver of an ox or cow had been placed. This would appear effectually to dispose of 



the idea that they are derived from any part of the skin unless some contamination 



had occurred.* The same remark applies to their successful inoculations of rabbits. 



I asked Dr. Maloiif to send me some more blood films and he forwarded ten, all 



unfortunately taken from one of the urticarial wheals, and numbered in the order in which 



they liad been taken. In none of them were X bodies found. The previous blood films 



had been made from finger blood. I now sent Dr. Malouf two tubes of Nicolle's blood 



agar and several tubes containing the 1 per cent, sodium citrate solution employed by 



Horrocks and Howell, and requested him to inoculate these tubes with appropriate 



quantities of blood taken from the finger as at first. This he kindly did, and I incubated Attempts at 



the inoculated media at or about 22° C. The tubes were examined daily for five days, care Culture 



being taken to secure the blood sediment from the citrate tubes. Unfortunately, coccal 



or bacterial contamination, apparently of cutaneoirs origin, eventually made its appearance 



in every one of the tubes and at no time were any X bodies found. I tried hard to get the 



patient to visit the laboratories but in vain, and before Dr. Malouf could obtain other blood 



films or make other blood cultures she left for Kamlin on the Blue Nile. Hence, much to 



my regret, I was unable to pursue the case further or to confirm the findings of Horrocks 



and Howell in culture media or to repeat and extend their inoculation experiments. 



Although one cannot express any opinion on these curious bodies their occurrence in 

 the Sudan is certainly interesting as is the fact that they were found in a case unassociated 

 with fever but suffering from a recurrent or intermittent urticaria. "f 



Mycetoma 



In the light of Brumpt's classification^ we are now in a position to say something 

 more definite regarding the varieties of mycetoma encountered in the Sudan. Plate XXIII. 

 shows four species of fungus grain namely Madurella mycetoma, Aspergillus houffardi, Four varieties 

 Indiella somaliensis and an unclassified species. 



It is not intended to enter into any detailed account of these forms. Brumpt's 

 excellent memoir deals fully with the subject, and the Sudan types, with one exception, 

 appear to answer to his descriptions. In the case of the last named, the diagnosis is 

 doubtful, for the specimen was received in spirit from Dr. Waterfield at Port Sudan and 

 it was not possible to carry out cultivation experiments. The grains, however, were 

 different to any hitherto seen, being of a rich brick-red colour, very hard and spherical in 

 shape. Captain Archibald, who examined the specimen, found, on crushing the grains, 



* JVntf. Mr. George Buchanan, however, drew my attention to the fact that some of the forms were present 

 on the slide beyond what one may call the "commencement end" of the blood film. This rather suggests that 

 they may have been derived fi'om the surface of the skin, especially as, in all probability, the slide was pressed 

 down U150U the tinger in order to take up the droi5, and not merely allowed to come in contact with the latter. 



t Since this paper was written, X bodies have been found by Major Eusor in blood films in a case of 

 indefinite fever in the Military Hospital, Khartoum, and in smears of blood obtained by splenic puncture in 

 a ease of Kala-azar and sent to the Laboratories from Gallabat in the Kassala Province. A few were also 

 encountered in a film of chick's blood made by a native attendant in the laboratories. None were found on 

 his skin. 



> Brumpt, E. (November 25, 1906). " Les Mycetomes." Arch, de I'urasif., Vol. X. No. 4, and iu 

 Prieis de Parasitologic. Paris, 1910. 



