STREPTOTHRICOSIS. 449 



what closely resemble the Streptothricce in their action in certain parts 

 of the body. 



Mycetoma may be defined and classified in one of three ways, if 

 Streptothrix is accepted as the most available generic name. 



(1) It may be considered as a clinical disease of multiple etiology 

 (which may or may not be limited to Streptothrix infections; (2) the 

 term may appropriately be made synonymous with streptothricosis, 

 actinomycosis, nocardiosis, etc.; (3) it may be made a clinical type (foot 

 infection) by a Streptothrix (Actinomyces or Nocardia\. Each of these 

 classifications has something in its favor and also may be criticised. 



The first would make diagnosis easy, for all forms of foot enlargement 

 giving certain clinical manifestations regardless of the etiology, known 

 or unknown, might be included, but it is open to the objection of not 

 being definite and does not conform to our present methods of etiologic 

 classification. 



The second method has much in its favor and is practically adopted 

 by Manson. The objections to it are that it adds a new significance to 

 a term which does not clearly express the conditions and also adds a 

 further synonym to a group of infections already rendered confusing 

 by the number of its synonyms. The difficulty can more satisfactorily 

 be met by the third method. 



We have therefore decided to follow the third classification making 

 mycetoma a clinical type or variety of streptothricosis — Streptothricosis 

 pedis — and to define it as follows: 



A disease consisting of a Streptothrix infection of the foot (Streptothri- 

 cosis pedis, Actinomycosis pedis), characterized by a chronic course, 

 swelling and deformity of the part, a peculiar, oily degeneration of 

 the tissues with cavity and sinus formations and the discharge through 

 the fistulous openings of nicotic aggregations containing the microor- 

 ganisms. 



Mycetoma, with this definition, becomes so intimate a part of strep- 

 tothricosis that a balanced conception of it can only be obtained by a 

 study of the whole subject of streptothricosis and a classification of the 

 organisms concerned. 



For this reason, the scope of this paper has been enlarged to include 



a discussion in two parts of the whole subject of Streptothrix or Nocarida 



infections. 



Part I. 



ORIGINAL WORE. 

 MATERIAL. 



The material for this paper consists of the following cultures : 



1. S. freeri Musgrave & Clegg, This Journal Sec. B. (1007), 2, 477. 



2. $. madurw Vincent. (This culture was sent to us b}' Professor Foulerton 

 who writes as follows concerning it: "This culture lias been in my hands for the 

 last ten years; it corresponds with Vincent's description of his organism, and 



