MYCETOMA, OR MADURA-FOOT. 267

fish-roe. It is the detection of these particles upon
which the diagnosis rests, and upon which the divis-
ion of the disease into the melanoid and pale varieties
depends.

The progress of the disease causes an enormous size
and a peculiar deformity of the affected foot or hand.
The malady is generally painless.

The micro-organismal nature of the disease was early
suspected. In spite of the confusion caused by some
who confounded the disease with and described it as
"Guinea-worm,7' Carter held that it was due to some
indigenous fungus as early as 1874. Boyce and Surveyor
believe that the black particles of the melanoid variety
represent a curious metamorphosis of a large branching
septate fungus, and that the white particles of the other
variety are the remains of a lowly-organized fungus and
of caseous particles.

Kanthack tried to prove the identity of the fungus
with the well-known actinomyces, but there seems to
be considerable doubt about the correctness of his view.

Vincent succeeded in isolating the micro-organism
by puncturing one of the nodes with a sterile pipette,
and has cultivated it upon artificial media. Acid vege-
table infusions seem suitable to its growth. It develops
scantily in bouillon at the room-temperature, better at
37° C.—in from four to five days. In twenty to thirty
days the colony attains the size of a little pea.

In the liquid media the colonies which cling to the
glass, and thus remain near the surface of the medium,
develop a rose- or bright-red color.

Cultures in gelatin are not very abundant, are colorless,
and are unaccompanied by liquefaction.

Upon the surface of agar-agar strikingly beautiful
rounded, glazed colonies are formed. They are at first
colorless, but later become rose-colored or bright red. The
majorit}r of the clusters remain isolated, some of them
attaining the size of a small pea. They are generally
umbilicated like a variola pustule, and present a curious