MADURA FOOT. 633 



remains unexplored. The inability to reproduce 

 the infection in animals at will renders a satisfac- 

 tory study of these questions very difficult. The 

 presence of large numbers of polymorphonuclear 

 leucocytes in the vicinity of the organisms sug- 

 gests, but does not prove, that they may have some 

 influence in combating the infection. Surely the 

 abundant mass of connective tissue which develops 

 about the abscesses and sinuses aids in confining 

 the process to a definite region. 



That the iodid of potassium has a curative influ- 

 ence on some cases of actinomycosis seems to have 

 been well demonstrated. The principles by which 

 it produces its effects are unknown. 



VI. MADURA FOOT. 



Mycetoma, or Madura foot, resembles actinomy- 

 cosis in the formation of abscesses, sinuses and 

 granulation tissue, but it shows a peculiar predilec- 

 tion for the foot, which probably is explained by 

 the greater exposure of this part to infection. This 

 disease differs from actinomycosis in that the 

 course is more chronic and it is never accompanied 

 by generalized infection. The bones are not in- 

 volved so frequently as in actinomycosis. Granules 

 similar to those of actinomycosis are found in the 

 cells, which, however, do not assume the pro- 

 nounced club shape seen in colonies of the ray fun- 

 gus. 



Two varieties of the disease are known, one in 

 which the granules are brown or black, and an- 

 other in which they are white or yellowish; the 

 latter is encountered much more frequently than 

 the former. 



