MORBID ANATOMY 213 



not restricted to the digestive tract. (4) In the skin and sub- 

 cutaneous tissue the lesions are found chiefly on the head and 

 neck. They usually consist of firm nodules from the size of a 

 hazel nut to that of a man's fist or even larger. Sometimes 

 these nodules are pedunculated and at others they are attached 

 to the skin by a broad base. Instead of the hard tumor there 

 may occur soft granular fungoid proliferations covered with a 

 brown crust or with a purulent secretion. At other times 

 minute nodules appear in these proliferations and the skin 

 becomes thickened and indurated. However, the skin lesions 



Fig 48. u^ciitiouiycosis of the tongue, ''ivoodcn longue.'' {Photo- 

 graphed by Hopkins.) 



may become very large. In this organ, the disease may be 

 either primary or secondary. (5) In the lymph glands 

 actinomycosis often appears in the lymph glands of the head, 

 larynx and pharynx. The parotid and submaxillary glands 

 are sometimes involved as secondary infections. It is reported 

 that the sub-parotid glands are most frequently affected. 

 (6) In the lungs the lesions vary. They may consist of firm, 

 somewhat yellowish nodules which eventually become cal- 

 careous in their center and vary in size from mere specks 

 to that of a pea. This form is spoken of as miliary actinomy- 

 cosis. In the second form the actinomycotic foci soften and 



