2I30 



MYCETOMA AND PARAMYCETOMA 



Potassium iodide may be tried, but as a rule internal medicines 

 and vaccines are useless for this form of mycetoma. 



Prophylaxis. — The wearing of boots and shoes and not walking 

 barefoot are apparently good and sensible methods of prophylaxis. 



THE ACTINOMYCOSES. 



Definition. — ^The Actinomycoses are those forms of mycetoma 

 with grains composed of very fine non-segmented mycelial filaments, 

 in which usually the walls are not clearly defined from the contents, 

 and in which chlamydospores are absent. 



History. — ^This period opens with Bollinger's epoch-making work 

 in 1876 on the lumpy-jaw of cattle, a disease which had been re- 

 cognized since 1785, and in which he found the constant presence 

 of a branching organism. This fungus was examined by Harz 

 (1877-78), who gave it the name Actinomyces bovis, but, most un- 

 fortunately, this generic name cannot stand, because, unbeknown 

 to Harz, it had already been used by Meyen (1827) ^^r a fungus 

 which he called Actinomyces horkelii, which is in no way related 

 to the group of fungi which we are considering. This mistake 

 launched the generic name applicable to these organisms on to a 

 sea of change, and led to much confusion. 



I. Nocardia bovis. — The correct name for Bollinger's organism is 

 Nocardia bovis (Harz, 1877). The fungus appears to have been first 

 seen in man by Israel in 1878. Corre (1883) was the first to draw 

 attention to the similarity between actinomycosis and the ochroid 

 variety of mycetoma, while Acland (1886) was the second observer 

 to demonstrate the presence of actinomycosis in man ; and as Israel's 

 name is associated with quite a different human actinomycosis, we 

 propose to name this variety Acland' s actinomycosis. In 1886, 

 Vandyke Carter, as we have already stated, also drew attention 

 to the likeness between actinomycosis and mycetoma. Finally, 

 in 189 1, Bostroem grew N. bovis from eleven cases of actinomycosis 

 in man, and since that time it has often been cultivated and de- 

 scribed. It is a nocardia with radially arranged filaments, which 

 show club-like enlargements of their extremities, caused by a pro- 

 tective thickening of the walls in animals and less commonly in 

 man, and having abundant Gram-positive but not acid-fast hyphse, 

 some of which end in chains of arthrospores. 



It grows well aerobically at 22° C, but better at 37° C. Anaerobic 

 growths are, as a rule, but poorly developed. 



It may form a dry pellicle on the surface of broth, but more 

 usually it gives rise to cohering colonies at the bottom of the tube, 

 and in either case the medium remains clear. 



It grows slowly on gelatine, producing a yellowish-white growth 

 and slow liquefaction, beginning about the seventh day. The 

 resulting fluid may or may not be dark coloured. On blood serum 

 it produces poor growths, and no liquefaction or pigmentation of 

 the medium. 



