2138 MYCETOMA AND PARAMYCETOMA 



mycetoma, this variety might be found to be more common than 

 Vincent's N. madum {=N. indica of Kanthack). 



Balfour (1911) reported the presence of the same causal agent 

 in a case of mycetoma of the hand in the Anglo-Egyptian Sudan, 

 and gave a photomicrographic illustration of the growth; and in 

 the same year Fiilleborn described and gave excellent illustra- 

 tions of a case from South-West Africa, which occurred in a 

 Herero aged twenty years. A study of Fiilleborn' s preparation 

 induced Brumpt to alter his generic diagnosis for the fungus which, 

 in 1913, he classified as Discomyces somaliensis, which, converted 

 into our present nomenclature, becomes Nocardia somaliensis 

 (Brumpt, 1906), but he is inclined to think that it ought to form a 

 separate genus or subgenus, for which he proposes the name 

 Indiellopsis Brumpt, 1913, because it secretes around itself in the 

 grain a hard sheath, insoluble in potash and in eau de Javelle, 

 which no other nocardia is known to do. 



In 1916 we met with this fungus in a mycetoma of the foot in 

 Khartoum. 



The grains are hard, i millimetre in diameter, and being of a 

 reddish-yellow colour, resemble the eggs of fish. The fungus will 

 not grow on hay or on dura broth, but it quickly produces a white, 

 lichen-like, folded growth, becoming yellow on the fifth to sixth day 

 on potato, but this growth never becomes red like that of N. indica. 



Genus Cohnistreptothrix. — In 1891, Wolff and Israel published a 

 beautifully illustrated account of a streptothrix, which they had 

 isolated from two cases of actinomycosis in man — viz., from the 

 lungs and from a retromaxillary growth. This organism was con- 

 sidered to differ from N. bovis in that it grew best anaerobically, that 

 branching was absent, and that its injections into animals were 

 regularly positive in their result. These three characteristics 

 induced Kruse, in 1896, to make a new species for it under the name 

 Streptothrix israeli. In 191 1, for reasons presently to be set forth, 

 Pinoy founded a new genus, Cohnistreptothrix, with Israel's organism 

 as the type species, and therefore its name becomes Cohnistrepto- 

 thrix israeli (Kruse, 1896). 



It appears to us to be of importance that the reader should clearly under- 

 stand the nature of the organisms included in this genus, and, therefore, we 

 digress from our main subject in order to give a brief history. 



Lachrymal concretions have been known since Cesoin described them in 

 1670. In 1848, Gruby, examining one of these objects, found it to be composed 

 of a fungus, which he believed to be the same as that causing favus ; but Cohn, 

 in 1875, examining another such concretion, also saw a fungus, for which he 

 created a new genus, Streptothrix, calling the fungus in question Streptothrix 

 foersteri Cohn, 1875, which may be the same organism as S. aureus Du Bois de 

 Saint Severin, 1895, and must be closely related to Nocardia tenuis Castellani, 

 1 91 1, which belongs to the same genus, and as its colonies on agar are ' cere- 

 briform,' it may possibly be the same or related to Streptothrix radiatus and 

 S. cerebriformis, both described from cases of keratitis by Namyslowski in 

 1909, as well as the more aerobic hyphal form of Silberschmidt's organism. 



Unfortunately, a mistake was made, for Cohn was not aware that the same 

 streptothrix had already been given by Corda, in 1839, for another and quite 

 different fungus, which is known as Streptothrix fusca Corda, 1839, and which 



