﻿478 MUSGKAVE AND CLEGG. 



taken from a patient encountered in the Massachusetts General Hospital, 

 although the author states that the etiologic relation of the Hyphomycete 

 remains to be established by animal experiment, Wright, in discussing 

 the ochroid variety of the disease, says that "at the present time the 

 ochroid or pale form of mycetoma must be regarded as actinomycosis of 

 the part." 



On the other hand, MacLeod, in Allbutt's System of Medicine, recog- 

 nizes Vincent's Streptothrix madurce as the cause of the ochroid variety 

 and states that it is a Streptothrix closely allied to, but differing from 

 Actinomyces. This author, referring to the black type, is of the opinion 

 that the fungus is a degenerate variety of the one causing the ochroid 

 form of infection, rather than that it is a distinct species. MacLeod 

 therefore considers the two varieties of the disease as being different 

 stages or types of the same infection and of a single etiology. Other 

 recent observers believe that the condition may be the result of the action 

 of several closely allied species of Streptothrix. 



We have isolated by culture and demonstrated conclusively the etio- 

 logic role of a new species of Streptothrix in a case of the ochroid 

 variety of the disease, as will be seen in the following report, and have 

 written to various colleagues for cultures of other organisms which have 

 been isolated from types of the disease. As soon as practicable we hope, 

 by a comparative study of these cultures and by observing their action on 

 monkeys, to determine the etiologic importance of the other cultivated 

 species of the Streptothrix. 



CASE REPORT. 



Mycetoma, ochroid variety; duration three years; amputation of foot; 

 recovery. Streptothrix (Streptothrix freeri sp. nov.) cultivated from 

 the lesions and its etiologic significance established. 



P. B. (St. Paul's Hospital. No. 3256). — A Filipina woman from the Province 

 of Bulacan; age 30, married., with two healthy children 2 and 5 years of age; 

 was admitted on August 5, 1907, to Musgrave's sen-ice in St. Paul's Hospital. 

 She complained of a large and painful right foot and stated that the disease 

 was of three years' duration. The family and previous history of the patient 

 furnished no data of importance. The patient stated, with reference to the present 

 disease, that about three years before admission, while she was doing laundry 

 work in the river, a sliver of bamboo entered the flesh between the great and second 

 toes of the right foot. The splinter was withdrawn and the wound then healed. 

 After about one month, pain in the region of the injury developed and the wound 

 again opened and discharged pus. Following the first lesion, other nodular lesions 

 developed in various places in the foot, and then subseqiiently opened and dis- 

 charged pus. The foot slowly grew larger until it attained its present size. 



The patient, on admission, is a somewhat frail, anfemic woman, apparently 

 about 40 years of age. although she states she is but 30. She says she is in 

 good health, were it not for pain and soreness of the right foot and her inability 

 to walk, because of the size and weight of this member. The heart and vessels. 



