THE ACTINOMYCOSES 



2131 



On agar and glycerine agar it forms hard, spherical, white colonies, 

 which give rise to an undulating crateriform growth, having a 

 yellowish or greyish tint, which in its turn becomes a lichenoid 

 ashen grey or yellowish mass with a powdery efflorescence. On 

 maltose agar it forms discrete fawn-coloured colonies, later 

 becoming yellow, dark brown, or even black, while the medium may 

 be slightly darkened. 



On potato it forms confluent, hard, raised, variously coloured 

 masses, at first white, but becoming greenish-yellow, brown, greyish- 

 black, or even black, with more or less erosion and pigmentation of 

 the medium to which the growth is very adherent. No diastatic 

 action has been observed. 



Litmus milk is first reddened, but later it becomes a clear brown 

 alkaline liquid. It is pathogenic for man, ox, horse, pig, and other 

 animals, while experimentally rabbits and guinea-pigs have been 

 infected, by intraperitoneal inoculation. 



2. Nocardia asteroides. — Nocardia bovis (Harz, 1877) is not the 

 only organism known to cause actinomycosis in man, for in 1890 

 Eppinger obtained an organism which he called Cladothrix asteroides, 

 and which is now known as Nocardia asteroides (Eppinger, 1890), 

 from the lesions in a case of pseudo-tuberculosis of the lungs and 

 pleura, with old caseous nodules in the apices and calcareous degener- 

 ation of the bronchial and supraclavicular glands, together with a 

 cerebral abscess which had ruptured into the ventricles. The 

 fungus was Gram-positive and acid, but not alcohol-fast, and grew 

 aerobically on laboratory media, and was pathogenic for laboratory 

 animals. It was afterwards recognized by Almquist, in 1890; by 

 Sabrazes and Riviere, in 1894; by Aoyama and Miyamoto, in 1900, 

 in Tokio; by MacCallum, in 1902, in America; and by Schabad, in 

 1903, in Russia. It is also the same as the fungus described by 

 Musgrave and Clegg (1907), in a case of mycetoma in the Philippine 

 Islands, under the name Streptothrix freeri. 



In 1909, Lindenberg, in Brazil, isolated a fungus from a case of 

 mycetoma of the left leg, which began in the popliteal space, and 

 to this organism he gave the name Discomyces brasiliensis. 



He was very careful to separate it from N. bovis and from 

 N. madiircB (N. indica), but he does not appear to have done so 

 with regard to N. asteroides. We therefore offer a comparison be- 

 tween the two organisms in the table on p. 2132. 



The inoculations into animals are not comparable, as Lindenberg 

 did not use monkeys. He was unsuccessful with a guinea-pig, but 

 does not say how he inoculated it, while Musgrave and Clegg were 

 successful by means of intraperitoneal inoculations. 



The differences as set forth between N. brasiliensis and N. 

 asteroides appear to us to be very shght, and therefore we are able 

 to agree with Pinoy in his behef that they are one and the same 

 organism. 



Also Cranwell, Bachmann, and Del Pont (1909) gave an excellent 

 and well-illustrated description of a yellow mycetoma in Buenos 



