MA D UROM YCOSES 



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produced such a serious condition that amputation became necessary. 

 This disease he had described in the same report for the preceding 

 year, designating it * morbus tuberculosis pedis/ because, though 

 he recognized it to be dissimilar from other recorded diseases, he 

 looked upon it as a local tubercular affection, and, influenced by 

 this view, he considered the black particles mentioned above to be 

 accidental, and not essential parts of the disease. He also mentions 

 that it was known to the natives as ' ghootloo mahdee,' from the 

 tubercular irregularities being supposed to resemble eggs. 



This first case of black maduromycosis occurred in a native aged 

 about thirty years, and had existed four to five years before ampu- 

 tation was performed. The morbid appearances are described as 

 being similar to those fully set forth in his 1844 report, with the 

 addition of there being in this instance one cyst (or excavated 

 tubercle) containing melanotic matter about the size of a small 

 walnut, and extending from the plantar to the dorsal aspect of the 

 foot, between the metatarsal bones of the great and second toes, 

 which were in part absorbed. The integuments were not involved 

 in this mass, which when recent had an angular and brilliant black 

 appearance much resembling a fragment of coal, and was considered 

 to be an accidental product in this peculiar case. 



Carter says that the second volume of the ' Indian Annals ' 

 (probably dated about 1849) P- 7^^ contains an account of 

 dark granular or black gritty particles being found among the bones 

 and in the sinuses of a diseased foot, but we have been unable to 

 refer to this work, and are ignorant of the name of the discoverer 

 and of the date and place in which this observation was made. The 

 particles in question were examined microscopically, and were 

 believed to consist entirely of dried blood, a belief which lasted for 

 many years. 



It may perhaps be advisable at this point to draw attention to the fact that 

 Ballingall's celebrated observations do not refer to the black, but to the yellow 

 variety of mycetoma, and hence do not enter into this history. 



Sub-Assistant Surgeon Bazonji Rustomji (1858), of the Bhoo's 

 Dispensary, in the Province of Kutch, drew attention to the fact 

 that there were two forms of the disease — viz., one in which there 

 was no granular deposit, but only a substance dark in colour and 

 soft and thick in consistence; while the other showed small, soft, 

 yellowish granules. This is the first occasion, as far as we know, 

 when a differentiation was made between the melanoid and the 

 ochroid varieties of the disease, but Rustomji did not recognize the 

 fungal nature of the bodies in question. 



Eyre (i860) states that in every foot examined by him there were 

 numerous minute tubercles resembling fish roe, which were found 

 lying beneath the muscles and extending from the bones to beneath 

 the skin, with nodules of the same appearance and often black in 

 colour. This paper deals with the external characters of the disease, 

 its previous history, natural course, morbid anatomy, aetiology (which 

 was doubtfully thought to be somewhat tubercular), and treatment. 



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