2134 



MYCETOMA AND PARAMYCETOMA 



latter variety was a true actinomycosis, and attempted to show 

 that the former was the same, only in a degenerated condition. 



He only examined the specimens microscopically, as no cultures 

 were possible, and named the fungus in question Oospora indica 

 Kanthack, 1893, calling his two varieties 0. indica var, flava and 

 0. indica var. nigra. The name of this fungus, translated into 

 more modern nomenclature, becomes Nocardia indica (Kanthack, 



1893). 



Boyce and Surveyor (1894) clearly proved that the melanoid 

 variety was due to quite a different fungus from that causing the 

 ochroid variety, which latter they considered in some, but possibly 

 not in all, cases to be an actinomyces, a conclusion in which they 

 were supported by Hewlett and by Boccaro. The latter analyzed 

 one hundred cases of Madura foot, of which the vast majority were 

 black mycetomas, while seventeen had evidence of pricks with an 

 acacia (Babul) thorn, in several of which it was found present on 

 examination. 



Kanthack's name appears to have been overlooked, but it cer- 

 tainly has priority as regards the fungus of an actinomycotic 

 nature causing the ochroid variety of mycetoma as seen in India, 

 but difficult of recognition in that it was not cultivated. 



In 1892, Gemy and Vincent described a parasitic disease of the 

 foot in Algeria, which they considered analogous to, if not identical 

 with, the ochroid variety of Vandyke Carter's mycetoma. 



In 1894, Vincent, still working in Algeria, met with a streptothrix 

 in a similar case. This fungus, which was first known as Strepto- 

 thrix madurcB Vincent, 1894, is believed to be identical with the 

 fungus found by Boyce in London in an agar tube inoculated in 

 India from a case of the ochroid variety of mycetoma. 



This streptothrix found by Boyce is, of course, an entirely different 

 organism from the mucor-like fungus called Chionyphe carteri 

 mentioned above, which therefore cannot be placed in the list of 

 synonyms of N. madurce, as has been done by some authors. 



Boyce's culture showed a fungus without club-shaped extremities 

 which grew very slowly on agar, glucose agar, and glycerine agar, 

 at a temperature varying between 35° C. and 37° C. No formation 

 of pigment was observed, but it was remarked that the organism 

 closely resembled that of actinomycosis. 



In 1904, Cornwall reported the cultivation of Vincent's organism 

 in India. He washed the grains in six changes of sterile salt solution, 

 and then planted them on agar in tubes. After an interval of one 

 or two months a growth appeared, which in some cases assumed 

 a pink colour and in others remained a dull white. In subcultures 

 it grew more freely, preserving its characteristics, one of which was 

 to adhere so closely to the medium that each nodule had to be liter- 

 ally dug out when it was required to transfer it to another tube. 

 Puff-balls formed in broth and hay infusions, while it was noted 

 that the fungus required plenty of oxygen for its growth and only 

 occasionally formed the pink pigment. 



