296 LEECHES 
it in pure culture, but his illustrations are very clear in showing 
the existence of the fungus.* He also gives in detail the methods 
he employed. It is to his work that we are indebted for the more 
careful description of the morbid changes. 
Morbid anatomy. As a rule the lesions are near the sur- 
face. Where the diseased portion has become well developed 
there is usually a more or less complete detachment of the 
central inflammatory growth from the surrounding tissue. This 
nodular or “kunker’” growth may vary in its density according 
to the stage of its development. During the early stages it is soft and 
easily cut; later it becomes firmer and ultimately assumes a hard 
or “‘gritty’’ character. 
In cutting sections it is generally the exception to cut through the 
nodule or kunker evenly and to have it retain its proper relations 
with the other parts. Even if suc- 
cessful in cutting, the nodule drops 
out after some of the other pro- 
cesses. In the specimens examined 
the lesions were confined entirely to 
the skin and subcutaneous tissue; no 
traces of muscular or glandular struc- 
Fic. 67. a SECTION OF THE LIP or ture were observed. Around the cen- 
a (Fish). tral portion of the inflammatory growth 
there is a zone of leucocytes of the 
mononuclear and polynuclear varieties, the latter predominating. 
They are embedded in an abundant stroma of connective tissue 
which is in a greater or less stage of degeneration. The central 
portion of the zone is in some cases very closely packed with the 
leuococytes, while toward the periphery they are more loosely 
arranged and cause a marked irregularity of the margin from their 
uneven drifting into the tissue beyond. There are generally one 
and perhaps more points where this infiltration occurs quite ex- 
tensively. In some of the preparations the wandering cells have 
been traced as far as the surface of the epidermis. 
The nodules are generally irregularly cone shaped and are of varia- 
ble size. In section they reveal a very dense structure, the frame- 
work of which forms a close reticulum. 
*There is considerable evidence that the “Summer Sore’’ in the northern states is 
due to a Streptothriz. 
