i66 



SaccJiaromycosis of tJic testicle, epididymis , mid the e.vterfial 

 genitals (Orchitis , epididymitis, fiiniciilitis saceharomycotica) : — 

 The morbid i:)rocess begins here mostly at tl e scrotum or prae- 

 putium, and by dessemination it is propagated over the tunica 

 vaginah's, testicle, epididymis, and the spermatic cord. By this 

 process an intergrowth of tunica vaginalis between tlie visceral 

 and parietal layers takes place. It is rarely the case that the 

 testicle is primarily affected without local cutaneous changes — 

 metastasis. The Jierd of the testicle is always circumscribed and 

 spherical in form, and its anatomical character is simulating that 

 of the lymphatic gland ; frequently it softens and is transformed 

 into an abscess. The content of the latter is thick and milk}-; under 

 the microscope we find in it myriads oi saccliaromyces^ lymph cor- 

 puscles enclosing the microbes, free nuclei, cocci-\'\\i& granules, 

 fat grains, &c. In the skin of the external genitals, scrotum, 

 penis, praeputium, the ulcers are funnel-shaped, the cavitj- being 

 filled up with wound secretion mixed with smegma, and in most 

 cases the local skin and subcutis s! diffuse thickening. 



SaccJini omycosis of internal organs: — The Inngs, which are 

 often the seat of glanders, are rard)- affected. What we find are 

 chronic indnrative pnennionia, plenro-pnenmonia, and in limited 

 cases ^rr/ nodnles simulating the malleous nodule. The chronic 

 pneumonia often appears in tlie anterior lobes, consisting of irre- 

 gular herds of variable sizes, pea, walnut, hand-breadth, and 

 even larger, either circumscribed or diffuse : on the cut 

 surface smaller nodules of from linseed to pea size are 

 found embedded in the primar\' Iwrd. Anatomically it be- 

 longs to the lobular pneumonia consisting of interstitial 

 cell infiltration around bronchioli and alveoles (PI. Ill, 

 Fig. 2), and in this tissue saccharomyces maj' be found but in 

 limited numbers, and not in all cases. The grey nodules are of 

 sinapis to linseed size, semitransparent and hard, either a few or 

 many scattered over the whole of the lungs, particularly met 

 with in the case of an extended nasal saccharomycosis. Unlike 

 proper malleous nodules a hyperaemic zone is here wanting. In 

 the spleen and liver we sometimes find a few metastatic abscesses 

 containing ordinary pus free from saccharomyces, and in the 

 kidneys multiple herds of chronic indnrative nephritis. Thus, in- 

 ternal changes in general, are not characteristic of Jap. farcj-, and 

 according to my present knowledge, the)' seem to be secondary 



