788 



Mycetoma, or Madura-foot 





'^K l!/J' 



actinomyces in structure. Boyce and Surveyor,* after studying 

 eighteen cases of the disease, concluded that the fungi present pre- 

 sented many of the characteristics of the fungus actinomyces. 

 Boycef later cultivated a streptothrix, from a case of Madura foot 

 that differed somewhat from fungi previously cultivated. Adami 

 and KirkpatrickJ believe that the fungus observed by them was 

 identical with the actinomyces. 

 It -seems probable, therefore, that Madura disease is a form of 



actinomycosis, caused by a parasite 

 best called Actinomyces madura. 

 It differs from Actinomyces bovis 

 in the greater ease with which it 

 is cultivated — if, indeed the organ- 

 isms cultivated are the same as 

 those observed in the sections. 



Morphology. — Under the micro- 

 scope the organism which belongs 

 to the higher bacteria, is found to 

 consist of long, branched threads 

 forming a tangled mass. The 

 peripheral filaments radiate from 

 the center, and form clubs much 

 like those of Actinomyces. In 

 some cases it is said that no clubs 

 were observed, in other cases that 

 they were longer and more slender 

 than in Actinomyces. 



Staining. — ^The organism stains 

 easily and holds the stain well 

 after Gram's method. It is not 

 acid-fast. 



Cultivation. — ^Vincent succeeded 

 in isolating the specific micro- 

 organism by puncturing one of the 

 nodes with a sterile pipette, and cultivated it upon artificial media, 

 acid vegetable infusions seeming best adapted to its growth. It 

 develops scantily at the room temperature, better at37°C. — in from 

 four to five days. In twenty to thirty days a colony attains the 

 size of a little pea. 



Bouillon. — In bouillon and other liquid media the organisms form 

 little clumps resembling those of Actinomyces. They cling to the 

 glass, remain near the surface of the medium, and develop a rose- 

 or bright-red color. Those which sink to the bottom form spheric 

 balls devoid of the color. 



* Trans. Royal Soc, London, 1894. 



t "Hygienische Rundschau," 1894, iv, p. 529. 



X Montreal Med. Jour., Jan., 1896. 



Fig. 3 14. — Actinomyces mad- 

 urse in a section of diseased tis- 

 sue (Vincent). 



