xiii, b, 4 Wade: Studies on Cryptoplasmic Infection 167 



material from a series of chronic, apparently mycotic ulcers, in 

 the fresh material from which no parasitic element could be 

 detected. These features have to do with the appearance in 

 the cultures of a differentiated fungous organism, apparently 

 as a result of certain peculiar changes in the very substance of 

 the cells of the infected material. 



This is a phenomenon so peculiar, so unlike anything known 

 to have been observed in the study of such infections, and so 

 radically different from the behavior of infectious organisms as 

 generally understood, that it quite overshadows in its possible 

 broader significance whatever interest attaches to the pathologic 

 condition from which the material was obtained. It constitutes 

 an essential contribution to the general hypothesis outlined above. 

 At the present time it is impossible to do more than describe 

 the findings in detail and discuss the apparent explanation. 

 Direct confirmation cannot as yet be had ; that must depend upon 

 future studies. Indirect evidence supportive of the explanation 

 suggested has been found in other studies yet to be reported. 



Chronic ulcerations of types not definitely classifiable are not 

 uncommon in the Philippine Islands and, apparently, in other 

 parts of the tropics. Many of these are doubtless assignable 

 to syphilis. Chronic ulcers, often associated with destructive 

 lesions, also occur as a late manifestation of yaws in districts 

 where this disease is endemic. There still remain, however, 

 ulcers that are not assignable with probability to any recognized 

 cause ; a small group of such lesions is the basis of this report. 



Few reports of investigations of such lesions in the Philippine 

 Islands are to be found. Strong 2 described three types of ulcers, 

 in sections from one of which he found bodies that he concluded 

 were fungous. The etiology of the other two remained obscure. 



Stitt, 5 before the Sixth International Dermatological Congress 

 (1907), said that failing to find tropical ulcer as described in 

 the textbooks he had concluded that it did not occur in the 

 Philippines, though ulcers due to neglected wounds and to the 

 infective granulomata were common. In Guam, also, none were 

 found, though extensive and mutilating ulcerations were fre- 

 quently seen. Among Americans, for the most part sailors in 

 the Naval Hospital at Cafiacao, Philippine Islands, he observed 

 two distinct types. One began as a painless swelling that later 

 began to ooze, resolving into a chronic ulcer, sometimes under- 



1 Strong, R. P., This Journal (1906), 1, 91. 



J Stitt, E. R., Journ. Cut. Dis. (1908), 26, 103; also ref. Journ. Am. Med. 

 Assoc. (1907), 49, 1305. 



