THE HIGHER BACTERIA 971 



pleomorphic bodies resembling micrococci. Similar organisms have 

 been noted by Klingler- 9 and recently in twenty-four cases by Cole- 

 brook" 011 whose paper the following description is based. In the 

 granules they appear as minute Gram-negative cocco-bacilli fused 

 together into sheets. In culture they grow aerobically or anaerob- 

 ically as minute coherent colonies which on agar are smooth and 

 glistening, in broth, starlike and frequently adherent to the sides 

 of the tubes. They grow on simple media but quickly die out in 

 culture. They form acid but no gas on sugars. Guinea-pigs and 

 rabbits may be killed by large injections but no lesions resembling 

 actinomycosis are produced. It is doubtful if these bacteria play 

 an important role in spontaneous cases of the disease. 



Actinobacillosis. A disease of cattle simulating actinomycosis, 

 in which granules with rays occur in the exudates has been described 

 in the Argentine by Ligniercs and Spitz and in England by Griffith. 31 

 Definite filaments were not found in the lesions and cultures yielded 

 a Gram-negative strepto-bacillus. One human case has been reported 

 by Ravaut and Pinoy. 32 



MYCETOMA (MADURA FOOT) 



The disease known by this name is not unlike actinomycosis. It 

 is more or less strictly limited to warmer climates and was first 

 recognized as a clinical entity, in India, by Carter. 33 Clinically it 

 consists of a chronic productive inflammation most frequently attack- 

 ing the foot, less often the hand, very infrequently other parts of 

 the body. Nodular swellings occur, which break down in their 

 centers, leading to the formation of abscesses, later of sinuses. Often 

 the bones are involved and a progressive rarefying osteitis results. 

 From the sinuses a purulent fluid exudes, in which are found char- 

 acteristic granular bodies. These may be hard, brittle, and black, 

 resembling grains of gunpowder, or may be grayish-white or yellow 

 and soft and grumous. According to the appearance of these granules 

 different varieties of the disease have been described as mycetoma 



*> Klingler, E., Centr. f. Bact., I, O; 1912, LXIL, 191. 

 Colebrook, L., Brit. Jour. Exp. Path., 1920, I, 197. 

 31 Griffith, F., Jour, of Hyg., 1916, XV, 195. 

 *-Ravcmt and Pinoy, Presse Med., 1911, XIX, 49. 

 33 Carter on Mycetoma, etc., London, 1874. 



