ACTINOMYCOSIS. 203 
with numerous fistulae from which escapes a pus more or less loaded with 
very small reddish-yellow masses resembling small gravel. Some forms of 
recent actinomycosis are neither ulcerated nor fistulous ; they resemble sar- 
coma very closely and their center is hollowed by one or more purulent 
centers whose contents hold the actinomycetes in suspension. Others 
already large and protruding exter- 
nally, are open deep down ona 
mucous membrane. In some cases 
secondary tumors are found irreg- 
ularly distributed round the primi- 
tive tumor or arranged in chaplet 
form. Under the microscope the 
actinomycetic mass appears made 
of diverging, regular or undulous 
filaments, sometimes ramified and 
ending with pyramidal enlarge- 
ments (conidia). This appear- 
ance in “umbrella” shape is suf- 
ficiently characteristic to permit the 
diagnosis. Fig. 50-—Actinomycoses boris magnified 
The treatment of actinomycosic goo. 
tumors includes the numerous means 
used against chronic inflammatory productions and against true neoplasms. 
Leblanc employed mercurial ointment and points cauterization; Cruzel, 
irritating frictions (spirits of turpentine and blistering liniments) ; Harms, 
applications of an ointment of equal parts of arsenious acid and lard. To 
dry the fistulee, injections of sulphate of copper, carbolic acid, ro per cent. 
(Rosenbach), and cauterization are recommended. These means have 
very generally failed. Extirpation of the tumor and the use of the curette 
have given better results in the case of external lesions. Where these 
“ osteosarcomata ” were treated early they gave way to surgical interference, 
but when the maxillary was invaded in a great part of its thickness, a 
secondary fracture was always to be feared. For this reason, in serious 
cases, it was better to have the animal destroyed. Some success has been 
attained in the case of man by the use of tuberculin (Billroth) and by electro- 
chemical treatment (Darier, Gautier). 
Numerous clinical facts obtained during the last few years prove that 
iodide of potassium is a true specific for the disease. Already in 1859 
Dupont had reported several recoveries of “ parotid indurations’”’ by a com- 
plicated treatment into which iodide of potassium entered. But it was 
Thomassen (1885) who demonstrated the remarkable therapeutic value 
of this compound. Used first against “wooden tongue,” which, was 
