SOME CLINICAL ASPECTS OF MYCETOMA, AN UNUSUAL 

 FORM OF CALLOSITY COMPLICATING IT. 1 



By A. Hootox. 1 



The Province of Kathiawar, on the west coast of India, to which the 

 following-trt5servations refer, is noted for the prevalence of mycetoma. 

 During the past two years 26 cases have come under my observation. 

 How this incidence contrasts with hospitals in other regions markedly 

 affected hj the disease I am not aware, but it is very much in excess of 

 the prevalence in any other station of which I have personal experience. 

 An interesting feature in this connection is the coincidence of actinomy- 

 cosis in the same area. At the Medical Congress held in Bombay last year 

 I reported two cases of that disease, which, so far as I know, has only 

 been once previously noted in India in man, namely, by Doctor Powell, 

 about ten years ago in Assam. There is so much in common patholo- 

 gically between mycetoma and actinomycosis that it is not surprising to 

 find them occurring in the same district. Indeed, it is somewhat remark- 

 able that this is not more often the case. 



Another unusual condition which impressed me early in my service 

 at the Eajkot Hospital, was a type of multiple callosity which I do not 

 remember to have seen elsewhere. Unlike the ordinary corn, these 

 callosities occur in parts of the sole not especially subject to pressure, and 

 they are also very much more extensive, so that in order to extirpate them 

 it is often necessary to excavate quite a large quantity of tissue. My 

 present observations are based partly on these callosities and their 

 occurrence side by side with mycetoma, and I think that the local 

 prevalence of the latter disease and the occasional conjunction of the two 

 conditions in the same subject afford some ground for the opinion which 

 I have formed that the one is merely a different phase of the other ; that 

 the callosity, in fact, is due to a horny degeneration or atrophy of a patch 

 of mycetoma. Additional weight is lent to this view by the fact that the 

 history is frequently the same. The patient often dates both undoubted 



1 Read at the first meeting of the Far Eastern Association of Tropical Medicine, 

 held at Manila March 12, 1910. 



2 Major, I. M. S., Rajkot, Kathiawar, India; delegate from the government 

 of India, 



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