314 ACTINOMYCOSIS 



contain a piece of bone about three inches long which had 

 become wedged between the teeth and cheek and surrounded 

 by inflammatory tissues. Frohner calls attention to conta- 

 gious diseases as possibly being mistaken for this disease. 



The affection recently described by Lignieres as adino- 

 bacillosis is to be distinguished from actinomycosis of the skin. 

 It is thought, however, by many workers that actinobacillosis 

 is a variety of actinomycosis. 



In making a positive diagnosis of actinomycosis it is 

 necessary to make a microscopic examxination of some of the 

 diseased tissue or of the discharged pus in which the ray 

 fungus may be found if the disease is actinomycosis. It is 

 impos-sible to obtain this positive proof from the living animal 

 when the disease is situated in the internal organs. With 

 these it is necessary to depend largely upon the history and 

 general condition of the animal. In preparing the discharged 

 pus for a microscopic examination it is usually sufficient to 

 crush one or more of the yellowish granules between a slide 

 and cover-glass. It is of advantage to wash it with a dilute 

 solution of caustic soda to clear away the pus cells. The 

 rosettes are easily recognized with a low magnification. 



In man, actinomycosis is to be differentiated from certain 

 forms of tuberculosis and the Madura foot disease which was 

 described by Carter, in i860, as a " fungus disease. " This 

 is a chronic, locall}^ spreading inflammation of the foot, rarely 

 of the hand, causing the destruction of the part involved and 

 giving rise to a great overgrowth of connective tissue. My- 

 cetoma almost invariably attacks the hand or foot and accord- 

 ing to Carter there are no secondary deposits in the viscera. 

 In actinomycosis the extremities are rarely attacked and the 

 viscera are often the seat of the disease ; further the mycetoma 

 is a disease of hot climates while actinomyco.sis is a disease of 

 the temperate latitudes. The fungus of the two affections 

 seem to be closely related but as yet their identity has not 

 been established. 



§ 234. Specific treatment. The investigations of 

 Thomassen, Nocard, and Norgaard and the experience of a 



