386 



Mycetoma, or Madura-foot 



and sinuses. The matter discharged from the lesions at 

 this stage of the disease is a thin sero-pus, and contains 

 occasional fine round pink or black bodies, similar to 

 actinomyces "grains," described, when pink, as resembling 

 fish-roe; when black, as resembling gunpowder. It is upon 

 the detection of these particles that the diagnosis rests. 

 According to the color of the bodies found, cases are divided 

 into the pale and melanoid varieties. 



The progress of the disease causes an enormous enlarge- 

 ment of the affected part. 

 The malady is usually pain- 

 less. 



The micro-organismal na- 

 ture of the disease was early 

 suspected. In spite of the 

 confusion caused by some 

 who confounded the disease 

 with "guinea-worm," Carter 

 held that it was due to some 

 indigenous fungus as early 

 as 1874. Boyce and Sur- 

 veyor found that the black 

 particles of the melanoid 

 variety consisted of a large 

 branching septate fungus. 



Pale Variety. Kan- 

 thack was the first to prove 

 the identity of the fungus 

 with the well-known actino- 

 myces, but there seems to be 

 considerable doubt about the 

 identity of the species. 



Morphology. Under the 

 microscope the organism is 

 found by Vincent* to be 



branched and belong to the higher bacteria. It consists of 

 long, branched bacillary threads forming a tangled mass. 

 In many of the threads spores could be made out. He 

 was unable to communicate the disease to animals by in- 

 oculation. 



Cultivation. Vincent succeeded in isolating the specific 

 micro-organism by puncturing one of the nodes with a 

 * "Ann. de 1'Inst. Pasteur," 94, 3. 



HI 



Fig. 114. Streptothrix Mad- 

 urse in a section of diseased tis- 

 sue (Vincent). 



