﻿ETIOLOGY OF MYCETOMA. 495 



Vincent and G-einy (1896) mention a second case of ochroid variety 

 and the cultivation of the same Streptothrix already reported by Vincent. 

 Preliminary mention was also made by these authors at the Congres de 

 Dermatologie et de Syphilis in Paris on April 25, 1892. 18 



Shattuck (1898) reported to the Pathological Society of London a 

 case which he designated as Mycetoma papillomatosum. The skin ex- 

 hibited a pronounced papillomatous condition, and secondary papillse 

 with sinuses and fungi were found within the larger growths. Mait- 

 land (1898) reported a case involving the thigh and abdominal wall of 

 a man, and Smyth (1898) published one involving the tissues of the 

 neck. 



Plehn, according to Scheube, observed three cases in Suahelinese on the 

 Tanga coast; however, probably these had been carried to that point from 

 India. Vincent mentions the fact that Layet encountered the disease in 

 Chile and Crookshank (1897) discussed the infection after collecting data ob- 

 tained by the examination of a specimen sent from India. Boecaro (1893) 

 analyzed one hundred cases, and in seventeen instances he saw evidence of a 

 prick by an acacia thorn. In many of these cases the thorn itself was found. 

 The same author also reports a case of mycetoma involving the tissues between 

 the vertebral column and the scapula. Descriptions of the infection are also 

 given by Delbanco (1897 and 1898); by Huntly (1890 and 1899), Kobner 

 (1891), Paltauf (1894), Ruelle (1893), Shah (1893) and the pathology is 

 fully outlined by Unna ( 1897) . 



The first case in America was reported by Kemper and Jameston, 19 but the 

 article is not available to us. 



Adami and Kirkpatrick 20 studied a case of the ochroid variety in Canada and 

 considered the granules to be identical in appearance with those from actino- 

 mycosis, and Hyde, Senn and Bishop (1896) reported one from Chicago. In the 

 latter instance the fungus suggested Actinomyces. No club-shaped forms were 

 seen, and in sections the central portion of the granules stained faintly with 

 hsematoxylin. Under high power, delicate, radiating filamentary threads were 

 observed in the masses. Delbanco, (1897) (according to Scheube) who studied 

 materials sent him by the authors reporting this case, concluded that it was acti- 

 nomycosis and not Madura foot. The record of Pope and Lamb's case (1896) is 

 not available to us. Arwine and Lamb 21 (1899) mention another case in a native 

 of Texas. Dr. Carroll who examined sections from the specimen considered the 

 disease to be actinomycosis. 



J. H. Wright 22 (1898) reviewed some of the literature of the subject and 

 reported one case of the melanoid variety from the service of Dr. Beach in 

 the Massachusetts' General Hospital in Boston. Wright's patient was an 

 Italian woman who had resided in the United States for several years, but the 

 disease had been noticed less than a year before she came under his care. The 

 clinical manifestations of the infection and the pathological alterations in the 

 specimen taken from this patient, as they are described by Wright, are very 



13 Ann. de dermat. (1892), May. 



19 Am. Practitioner (1876), 577. 



20 Trans. Ass. Am. Physicians (1895), 10, 92, and Montreal Med. Journ. 

 (1905-6), 24, 485. 



21 Am. J. Med. 8c. (1899), N. S. 188, 393. 



22 J. Exp. Med. (1898), 3, 421. 



