BY C. ,r. POtTNI), F.R.M.S. XVll 



the throat, bone cancer, spina ventosa, chronic abscess, caries of 

 the bone, etc. Although these various names were each supposed 

 to represent a distinct form of disease, recent researches with the 

 aid of the microscope have shown that they are one and all the 

 same, and consequently are now classed under one head — viz.^ 

 Actinomycosis. From the early part of the present century till 

 IB?;*) numerous well-known observers, including Dick, Langenbcck, 

 Lebert, Rivolta, .Tohne, Robin, and Perroncito, wrote most 

 elaborate essays on this disease. None of these observers, how- 

 ever, proved conclusively the true nature of the cases which they 

 described. In 1H76 Bollinger threw an entirely new light on the 

 subject by the accurate description and identification of the 

 characteristic micro-organism which has given the name to this 

 disease. His investigations applied only to cattle ; but in 

 the following year J. Israel described a similnr affection 

 in man. and in 1879 Ponfick brought strong evidence to prove the 

 identity of the disease in man with that which occurs in cattle. 

 Since this time the identity of the two diseases has been generally 

 recognised, though no definite casual relation has yet been traced 

 between them. 



In advanced stages of the disease the fungus may be detected 

 with the naked eye in the muco-purulent discharge or in a 

 scraping from the ciit surface of a growth. The tufts of the 

 fungus vary in size under different circumstances from a grain of 

 sand to that of a pin's head, and appear to be yellowisli white in 

 colour. On examination i;nder the microscope these l-ittle tufts 

 appear to be made up of a mass of club-shaped bodies resembling, 

 to a certain extent, soda-water bottles with the narrow ends 

 attached to the centre, thus forming a delicate-rayed rosette ; in 

 fact, they will call to mind, on focusing in turn the centre and 

 the periphery, the appearance of a composite flower. 



In some cases, especially in the early stage, the fungus is 

 made up almost entirely of a mass of delicate filaments or 

 mycelium, which have been proved by numerous observers to be 

 the active or vegetable stage of the organisms. My friend Prof. 

 Crookshank, of King's College, London, has shown that the club- 

 shaped end is in reality the the terminal part of the filaments ; 

 moreov*?r, he is of opinion that the clubs are mucilaginous 



