TDMORS 127 



tissues all form one solid mass, the skin at the most dependent 

 part showing fistulous openings leading into tracts of various 

 depths. 



On section, the surface is grayish white, showing here 

 and there softened foci containing a muco-purulent semi- 

 fluid holding the botryomyces. 



Describe the hotryomycoma of the mammary gland. 



This is of rather malignant disposition, very likely to 

 recur after excision, and has a decided tendency to invade the 

 surrounding tissues. The part of the udder involved feels 

 hard and nodular ; there may he fistulous openings and 

 abscesses present, the affection occasionally spreading to the 

 abdominal parieties and thigh. 



Describe the hotryomycom,a of muscles. 



These are quite often seen at a point where the mastoido 

 humeralis covers the point of the shoulder, representing a 

 form of the so-called shoulder abscesses. They differ but 

 little from those described under hotryomycoma of the skin. 

 Other muscles in which they are observed are those of the 

 belly, intercostal muscles. Botryomycosis of bones seems to 

 be very rare. One case is on record where the tumor 

 developed from the maxillary sinus. This tumor, springing 

 from the mucous lining, became as large as a child's head in 

 twcJ months, causing a bulging of the maxillary and frontal 

 bones, unilateral nasal discharge and nasal dyspnoea. Gen- 

 eralized botryomycosis has been described once; it was a 

 mare, the primary point of infection being the uterus. Those 

 botryomycomata found in internal organs have no practical 

 surgical interest. 

 How do you treat botryomycomata 9 



They are best excised, carrying the knife well into the 



