I82 



proliferation resulting' in elepliantiasis with vigorous big and 

 vasculous granulations, and in the latter we find cavities, filled 

 up with atheromatous matter, which is never absent in HiinusJii, 

 while nodes and abscesses, characteristic of Jap. farcy, are 

 wanting. 



4. The wound secretion consists not of pus bonuui, but ot 

 thick, thready fluid somewhat resembling synovia. 



5. Hiinushi always appears in summer, and when the 

 weather cools the wound heals spontaneously. 



iii. Gangrenous grease and some other kinds 

 of phlegmone of extremities. 



These affections may lead to confusion, when they result in 

 a chronic thickening or ulceration of the skin and subcutis. 

 Recently we observed an epizooty of gangrenous grease in the 

 Tram-car Company at Shimbashi. The epizooty suddenly ap- 

 peared with a profound phlegmone, hot and painful swelling and 

 febrile symptoms followed by gangrenous destruction of the skin 

 and subcutis. Then appeared round or oblong ulcers of different 

 sizes, dollar to hand-breadth or even larger, with distinct thicken- 

 ing at the border and bottom of the ulcer. The clinical appear- 

 ance was nearly the same as that of Himushi, without, liowever, the 

 symptoms of itching and atheromatous degeneration. The seat 

 was mostly the hollow of fetlock and also the upper part of the 

 extremities. We found a special kind of pathogenic streptococ- 

 cus,^^^ whose aetiological relation had been proved b\' inoculation 

 experiment. In the case of extended ulceration confusion is 

 possible witli saccharomycosis ; but this disease is, like Himushi, 

 confined to a single part especially of the extremities, and it 

 shows neither nodules nor ulcers so characteristic of saccharo- 

 mycosis. 



iv. Traumatic ulcer. 



This can be easily diagnotized, but such wound of extre- 

 mities is frequently infested with saccharomyces (Case XXXIll). 

 On v/atching a further course we find, in the case of infection, a 

 cordy swelling or formation of abscesses in the neighbourhood 

 along the course of the lymphatics. 



(I) Maize found streptococci in the grease of horse and concluded it to be tlie same 

 affection as erysipelas in men (Jahresbericfit B. IX). 



