1889.] MICROSCOPICAL JOURNAL. 103 



Once implanted in the tissues there seems to be no means of arresting 

 its ravages, for although much of it is carried off in pus, there is always 

 an increase, as the invasion of new tissue by the fungus is constantly 

 going on in advance of the suppuration, which seems to be the only 

 means of getting rid of it, and this through caries of bones and multiple 

 abscesses ends only in the death of the unfortunate victim. I will 

 quote from the Annual of the Universal Medical Sciences, 188S, vol. i, 

 a report of one case of primary actinomycosis of the brain : 



" Bollinger, of Munich, reports the case, which he considers unique 

 (the only one out of $9 cases of actinomycosis in man) : Female, age 

 26 years, complained of headache one year before death. A month 

 later temporary paralysis of the left abducens. Eight months later, at- 

 tacks of headache, diplopia, difficult speech, choked disks ; occasionally 

 loss of consciousness. Temporary amelioration. Death after head- 

 ache, vomiting and coma. Autopsy showed a tumor, size of a walnut, 

 in the third ventricle, apparently developed from its choroid plexus. 

 The surface was smooth, and its color pale yellowish-gray. There was 

 internal hydrocephalus. Microscopic examination revealed the usual 

 appearances of actinomycotic masses. The author thinks it probable 

 that the germs were absorbed with raw goats' and cows' milk, which the 

 patient was in the habit of drinking largely ; from the intestinal tract it 

 had reached the brain by embolism, through unknown channels. Only 

 three cases of actinomycosis have been thus far observed in Bavaria." 



The disease is infectious, as not only will inoculations with pieces of 

 the tissue or pus containing the fungus cause the disease, but cultiva- 

 tions have produced the same result. 



The disease has been found in the cavities of carious teeth, in the 

 tonsils, and as a secondary deposit even in the cavities of the heart. 

 The exact nature and botanical position of the fungus are in doubt ; it 

 may be the conidia form of some known species. For the slides con- 

 taining the fungus that I have here to-night I am indebted to Dr. I. 

 W. Blackburn, special pathologist of the Government Hospital for the 

 Insane in this city, and vice-president of this Society. The sections 

 are four in number, and in reply to my inquiries as to when and where 

 the case occuiTed, the tissue used in making the sections, and how pre- 

 pared, he informs me as follows : 



" The specimen of actinomycosis was found by our house steward 

 on inspecting some beef bought of one of the great " dressed beef" 

 companies of our city for the use of the hospital. He rejected the 

 piece and brought it to me for examination. I found it to be the so- 

 called " knee-joint " of the fore-quarter, which was pretty extensively 

 diseased. The butcher had removed some of the diseased tissue, but 

 quite a mass yet remained. I recognized it by the naked eye, by the 

 presence of the minute masses of fungus scattered through the tissue, 

 and confirmed the diagnosis by the hastily prepared specimens I was 

 obliged to give you. 



" This is all the history I can give you of the case, I am sorry to say. 

 It shows the care with which all dressed meats should be examined, 

 though probably if well cooked actinomyces would be palatable and 

 nutritious, and possibly perfectly safe." 



These slides were not prepai'ed with any special process for bringing 

 out their structure, but the following note may serve to show how this 

 may be done : 



