174 The Philippine Journal of Science 1918 



rather than to a special capsular structure. Wide variation in 

 density of staining was often apparent. Young individuals (and 

 particularly those in case I) tended to stain solidly (figs. 51 

 and 52). Older organisms (and particularly those in case II) 

 were often granular (figs. 54, 55, and 56), some granules stain- 

 ing red by Giemsa's. In many groups some were unstained (fig. 

 59), appearing in stained, wet-mounted preparations as coloiless 

 hyaline bodies. 



Multiplication took place by a peculiarly clumsy gemmation 

 that sometimes approached binary fission (figs. 54, 55, and 57). 

 It was evidently a very slow process, for though many individuals 

 exhibited it, the numbers of cells produced were not great. 

 Microscopically masses of them were found (fig. 49), but nothing 

 approaching visible colonies was ever attained. 



Cultivability was so low that in no transplant, even on the 

 media ordinarily most favorable to fungus growth, was any 

 development observed. It seemed as if the remnants of tissue 

 elements were essential to their multiplication. When this was 

 dispersed on fresh media, or exhausted in the original cultures, 

 growth ceased, and the organisms did not long survive. It is 

 possible that, together with special suitability of the medium 

 (nutrient prune agar) , symbiosis with the accompanying bacteria 

 also may have had an influencing role in their development. 



DETAILS OF CASES AND CULTIVATION WORK 



In these reports the common descriptions, including the find- 

 ings in smears and in sections of tissue fragments where such 

 were examined, will not be detailed. 



CASE I 



"Mycetomalike" foot with ulcers. — M., Filipino rice farmer, aged 56 

 years, from a barrio somewhat distant from Hagonoy, seen August 17, 

 1916. The condition began with a painless soft tumor on the dorsum of 

 the left foot two years ago. This did not ulcerate at first, but extended 

 in the deeper tissues, the skin later breaking down and producing an ulcer 

 that slowly enlarged, finally healing for the most part. When seen, the foot 

 and ankle were thick and heavy, with marked induration extending from 

 just behind the toes to above the ankle. The whole was rather suggestive 

 of a mycetoma, except that there were no sinuses or discernible subcutaneous 

 foci of necrosis. No bone destruction was evident. An area of skin over 

 the dorsum was ulcerated, with scar tissue about it. Above this, on the 

 ankle, was a large fungating ulcer (6 to 8 centimeters in diameter) said 

 to be of about one year's standing. The floor was made up of soft pale 

 granulations, from which material was removed for cultures and sections. 

 I was unable to see this patient again, but the Commission surgeon reported 

 that under potassium iodide the active lesions subsided completely. 



