180 The Philippine Journal of Science i9is 



for about 1 centimeter downward, forward, or upward. The process had 

 confined itself to the subcutaneous tissue. Upon incising the overlying 

 skin, the cavity was found to be lined by a thin layer of pale necrotic 

 material over vascular inflammatory tissue. 



Because of its situation no tissue was removed from the floor, and only 

 a small piece was removed from the skin itself. Smears showed bacteria, 

 but nothing else of interest. The tissue section is shown in fig. 7. 



Small bits of tissue were planted on nutrient banana and 

 nutrient prune agars. On November 25 both tubes showed 

 bacterial growth, more on the banana than the prune. In 

 smears from the former none of the cell-fragment forms were 

 found, though a few were present on January 2, at which time 

 the material was transplanted to plain and fresh nutrient ba- 

 nana agars. On January 17, these cultures being negative, they 

 were sealed with paraffin and put aside at body temperature. 

 On February 20 they were still negative and were discarded. 



The nutrient prune culture had shown (November 25) a few 

 suggestive forms. Transplants were made (January 2) from 

 this to plain and (fresh) nutrient banana agars. On January 

 17 the nutrient banana subcultures showed heavy staphylococ- 

 cus growth and practically no forms of interest. On the plain 

 banana, however, on which the bacteria were largely inhibited, 

 numbers of cell fragments were found. All tubes were paraf- 

 fined and put away at body temperature. On February 20 only 

 the two plain banana cultures showed a few cell-fragment forms ; 

 a few were still to be found on March 16, but attempts to stim- 

 ulate development were unsuccessful. A rabbit (R. Ill) was 

 inoculated in the anterior chamber without result. 



Comment. — This, the earliest case in the series, I found ac- 

 cidentally in the clinic as it was being dressed as an insignificant 

 lesion by the clinic attendant. So far as the preliminary find- 

 ings indicate, it is probably of the same nature as the above 

 cases. 



CASE VI 



Inflammatory tumor beneath scalp. — The patient, Filipina, aged about 

 30 years, complained, when seen August 3, 1916, of a painful tumor of the 

 size of a small olive beneath the scalp on the left side. This had troubled 

 her increasingly for three weeks, finally preventing sleep. The mass was 

 adherent to the bone, not to the scalp, and was painful, firm, not fluctuant. 

 The patient presented no other lesions. 



Exploration by needle elicited no evidence of necrosis or suppuration. 

 Incision was not permitted. By aspiration two or three drops of bloody 

 fluid were obtained. In a single culture on dextrose agar this was 

 negative. Microscopically no organism was found. High lymphocyte and 

 eosinophile content (above 10 per cent) suggested a chronic inflammatory 

 condition. 



