MYCETOMA 



2III 



Definition. — The term ' mycetoma ' includes all growths and 

 granulations which produce enlargement, deformity, or destruction 

 in any portion of the tissues of man or animals, and which are 

 caused by the invasion of the affected area by fungi belonging to 

 different genera and species, which produce bodies of varying 

 dimensions, colour, and shape, composed of hyphse, and sometimes 

 chlamydospores, embedded in a matrix. These bodies, which are 

 capable of giving rise to mycelial filaments, on germination, are 

 termed ' grains,' and are found either embedded in the pathological 

 tissue forming these growths and granulations, or escaping freely in 

 the discharge therefrom. In addition, eosinophile bodies can usually 

 be seen. 



Early History — According to Waring, as quoted by Collas, the 

 Sanscrit work * Vaweda,' by which is probably meant, ' At'harva- 

 veda,' describes a disease of the foot termed ' padavalmicum/ 

 which causes swelling and the formation of little fleshy tumours, 

 which, after an interval of a year from the commencement of the 

 disease, discharge a peculiar fluid. 



This disease is distinguished from another malady of the foot 

 which is called ' slipatham,' or elephant foot. 



If the above is a correct quotation from the ' At'harvaveda,' then 

 the Ancient Indian surgeons must have distinguished elephantiasis 

 of the foot from such conditions as might have been produced 

 therein by mycetoma, yaws, etc. 



It is, however, curious that, like Collas, we have been unable to 

 find any account of such a disease in the writings of Susruta. 



The term 'perical,' used by Kaempfer in 1712, is applicable to an^^ 

 enlargement of the foot, whether caused by elephantiasis, mycetoma, 

 or yaws, but the Pondichery missionary of 1714 appears to have 

 seen the disease mycetoma, and possibly the actinomycotic variety, 

 because he describes under the term ' fourmiliere des vers ' an in- 

 curable disease of the foot in which numerous small ulcers form, 

 which intercommunicate by means of canals full of worms. These 

 canals are described as being peculiar in that if one closes another 

 opens. 



Heyne probably recognized some sort of a mycetoma, in 1806, 

 in the foot of the Rajah's brother at Cuddapah, and Brett's ' adipose 

 sarcoma,' described in 1840, may have been of the same nature. 



Madura Foot Period.' — With the closing years of the last period 

 it will be noticed that it began to dawn upon the medical men of 

 India that there existed in that country a peculiar disease of the 

 foot, and this was emphasized by Gill of Madura, who, in 1842, 

 described a condition of that member which was characterized 

 by marked deformity and fungoid excrescences, from which flowed 

 an offensive ichorous discharge, while internally the disease pro- 

 duced a condition resembling fibro-cartilage, and destroyed joints, 

 cartilages, and ligaments. 



Four years later, Colebrook, Gill's successor at the Madura 

 Dispensary, confirmed these observations, and stated that the 



