2ll6 



MYCETOMA AND PARAMYCETOMA 



Notwithstanding all these researches, a great deal of confusion 

 still existed with regard to the disease, which can be judged by a 

 study of Fox and Farquhar's (1876) report. It was admitted that 

 the black granules were fungal in nature, but it was contended that 

 they were not causal in effect, because all the essential features of 

 mycetoma were found to be present without any black fungal 

 particles, and because there was not sufficient evidence forthcoming 

 at the time in proof of the vegetal character of the yellow grains, 

 which were believed to be essentially fatty in nature. It was, 

 however, admitted that Moore's observation showing that the black 

 variety could be cured by excision of all the particles at an early 

 stage of the disease was a strong argument in favour of the parasitic 

 nature of mycetoma. 



Though Carter had found black, yellow or white, and red grains, 

 still the general belief was that these were one and the same process, 

 and, moreover, observers of this period must have seen the pseudo- 

 mycetomatous conditions mentioned above, because competent 

 workers appear to have met with cases in which they were unable 

 to find any grains, although the clinical appearances resembled 

 mycetoma. 



Corre (1883) placed in order, completed, and revised the notes 

 of researches made by Collas since his publication, already men- 

 tioned, in 1861. In these notes, which were published after his 

 death, Collas desired his previous name for the disorder to be altered 

 to ' La Maladie de Ballingall,' and states that the earliest references 

 to the disease with which he is acquainted can be found in Waring's 

 paper, and in one of the sacred books of the East which he calls 

 ' Vaweda ' (Ushta wunga hrethayum) , which appears to us to be the 

 ' Atharvaveda. ' In this latter work, ' slipatham,' or elephant foot, 

 is distinguished from ' padavalmicum,' which refers to an incurable 

 malady of the foot associated with swelling and the formation of 

 fleshy tumours, from which, about a year after the appearance of the 

 first symptoms, there exudes a peculiar fluid. He also points out 

 that the words ' perikal,' ' anaikal ' (Tamil)^ — this means Cochin 

 leg — slipada ' (Bengalese), ' hatty-ka-poung ' (Deccan), are applic- 

 able to elephantiasis as well as to Madura foot, and, therefore, should 

 not be specially applied to the latter, as they really mean the 

 ' leg of an elephant.' In Ballary, he says, the disease was called 

 ' gootloo mahdee,' because the swellings on the foot were thought 

 to be like eggs; while in Rajputana it was called ' kirinagras,' or 

 the dwelling-house of worms, because the sinuses were considered 

 to be like the cavities often occupied by the larvae of flies. He also 

 says that in 1714 a missionary described under the name of ' four- 

 miliere des vers * a disease of Pondichery which was incurable, and 

 in which numerous ulcers intercommunicated by means of small 

 canals full of worms, which were peculiar in that if one closed 

 another opened. This information Collas obtained from vol. ii., 

 p. 167, of a book published in Paris in 18 12, and entitled ' Memoires 

 sur les moeurs et coutumes de I'lnde par un missionaire.' Collas 



