62 
GEORGE FLEMING. 
small fistulous opening, from which a whitish-yellow pus flowed, 
but which, having ceased, the opening healed, and the swelling 
became somewhat less prominent. Shortly before this period 
he saw a similar tumor, slightly larger, which, like the other, was 
attached by strong connective tissue to the structures beneath. 
On examination both tumors were found to be actionomykomata; 
they were the size of, or bigger than large walnuts, spongy in 
texture, and full of the fungus tufts enclosed in a capsule of 
thick connective tissue arising from between the sub-cutis and 
the inter-muscular connective tissue. 
Rabe relates the case of a cow, which had a number of pale, 
greyish-red tumors, round or somewhat bean-shaped, and of vari¬ 
ous sizes, on the left side of the face. The largest, about the 
size of a hen’s egg, was situated at the outer margin of the nos¬ 
tril, where the cutis joins the mucous membrane, and was sur¬ 
rounded by a number of smaller and very small tumors. There 
were eleven others, varying in size from that of a hazel-nut to a 
plum, in the masseteric region ; these were more or less apart, but 
between them were smaller ones, and here and there a marked 
cordiform kind of swelling—not unlike the inflamed lymphatics 
of farcy. The majority of the tumors lay immediately beneath 
the skin or the fascia of the facial muscles ; the surface was 
smooth, and each tumor seemed to be isolated from its fellows. 
Over some of them the cutis had become ulcerated, and they 
appeared on their upper surface moist, red, and fungoid. 
On section of these tumors there were observed a great num¬ 
ber, particularly towards their periphery, of dull-yellow nodules 
the size of a pin’s head, in the neighborhood of which the tissue 
was soft, spongy, and moist. On microscopical examination each 
of these yellow, submiliary granules was found to contain the 
Actinomyces tufts in abundance, and in their immediate vicinity 
a great quantity of pus-corpuscles and young connective-tissue 
cells, with very turbid protoplasm, and other characteristic ap¬ 
pearance. 
{To be continued .) 
