2I20 



MYCETOMA AND PARAMYCETOMA 



on this part of the subject is required, but from the above it is 

 obvious that heat and aridity are favourable conditions for the fungi 

 which cause black maduromycosis. 



Botanical and Zoological Distribution. — Unfortunately, we are 

 in complete darkness as to the characters which the fungi causing 

 black maduromycosis assume when not living in animals or on 

 artificial culture media. 



Even with regard to those forms of black maduromycosis due to 

 an aspergillus, we are quite ignorant as to whether this particular 

 fungus lives on soil or on plants. 



Etiology. — ^The outstanding feature of microscopical specimens 

 prepared from a case of maduromycosis is the presence of coloured 

 granules, black in black maduromycosis, whitish or yellowish in 

 white or yellow maduromycosis, and red in red maduromycosis. 



These coloured granules are called ' grains,' a term which has been 

 defined by Chalmers and Archibald as follows: — 



'The term "granum" or grain has been given to differently 

 coloured bodies of varying consistence, size, and shape, found in 

 mycetomas, and composed of hyphae, with sometimes chlamydo- 

 spores, embedded in a matrix and giving rise to mycelial filaments 

 on germination.' 



The aetiological importance of these grains and their contained 

 fungus rests upon the fact that they are present in all forms of 

 maduromycosis and are co-extensive with the disease, while their 

 complete removal effects a rapid and complete cure. 



Animal inoculations have been successful in some varieties, thus 

 affording, in these instances, a full and convincing proof of the aetio- 

 logy of the fungus — e.g., Pinoy's and Pepere's varieties. 



The aetiological features of the various forms of maduromycosis 

 are set forth below in a list which shows the Maduromycoses classified 

 — firstly, by the colour of the grain ; secondly, by the geographical 

 distribution; and thirdly, by the discoverer's name or names. 



I. The black maduromycoses, with black grains. 



II. The white or yellow maduromycoses, with white or yellowish 

 grains. 



III. The red maduromycoses, with red grains. 



1. THE BLACK MADUROMYCOSES. 

 These may be divided into : — 



A. The European black maduromycoses. 



B. The African black maduromycoses. 



C. The Asian black maduromycosis. 



D. The American black maduromycoses, 



A. The European Black Maduromycoses. 

 (i) Bassini's, Kobner's, and Schmincke's black maduromycoses, 

 respectively found in Padua, Italy, and in Kissingen, and of which 

 the nature of the aetiological fungus is unknown. 



