384 The Fungus Disease of India. [part ii. 



In the pale variety this product is for the most part of a fatty nature, abounding 

 in many of the various modifications of fat known to pathologists ; whereas in the 

 dark variety, the fatty matter forms a far less prominent feature in some cases ; 

 indeed, the dark material may often be referred to as being almost completely devoid 

 of fat — at all events it must have undergone such extensive changes as to be no 

 longer recognisable as such. 



It is extremely difficult to account for the discrepancy in the composition of 

 the morbid products of the disease. The inference that the pale is a later stage of 

 the dark variety of the affection, as advocated by Dr. Vandyke Carter, is in our 

 opinion untenable from the fact that, as has been shown on a previous page, the 

 progress of the disease may, in some cases, be traced through all its stages in a single 

 specimen ; just as in a tuberculised lung areas may often be distinguished presenting 

 the most recent deposits of tubercle in the midst of tissue far advanced in the 

 degeneration. In Specimen III (page 349), for example, the various steps in the 

 degenerative process could be followed with the greatest ease. Well defined areas 

 could be seen in the midst of, apparently, healthy connective and fatty tissues, and 

 the various stages of the process — trifling consolidation of defined areas of tissue, 

 slight discoloration, nests of roe-like bodies associated or not with crystalline formations, 

 and other changes, could be readily identified, but without any indication of the previous 

 existence of the black substance. 



On the other hand we have seen specimens of the dark variety in such a 

 recent stage of the development of the malady, as to negative any idea of its being 

 a later stage of the pale ; the dark granules not larger than grains of gunpowder 

 being deposited here and there among the tissues ; the only concomitant alterations 

 of the part being slight hardening and trifling discoloration of isolated lobules in 

 the subcutaneous tissue. In one case (Specimen II, page 347) we were able to 

 trace, what appeared to us to be, the progressive stages, in this variety also, of 

 the malady — from the yellowish-brown ceruminous nodule, to the almost perfect 

 black, granular lump. 



It is nevertheless quite possible, and indeed probable, judging from the great 

 similarity in the lesions produced, the course pursued by the disease, and its 

 duration in the two forms, that the original cause may be very closely allied if 

 not identical. Pathology has not yet progressed sufficiently to be able to determine 

 why it is that certain degenerations will take very different courses in different 

 persons ; nor is the science sufficiently advanced to enable us to refer definitely to 

 the direct cause of almost any single degenerative process. For the most part our 

 etiological conceptions are hypothetical. Consequently we are no further behind in 

 our knowledge of the etiology of this, comparatively, new disease, than we are 

 with reference to causation of the various cancerous and other morbid processes 

 which have been known for centuries. 



But do we know imore as to the cause of this disease than we do of most 



