On mycetoma, or, The fungus disease of India / by H. Vandyke Carter.

Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: On mycetoma, or, The fungus disease of India / by H. Vandyke Carter. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    foot, being, at any stage, devoid of its attendant cliaracteristics. A combination of tbe fungus-disease with other local maladies, has yet to be made out. When, after careful searching, neither black, tinted nor pale particles are to be found in any part of a peculiarly disorganized foot, I pronounce the affection to be different from Mycetoma; and the observer of such a malady as this, would, in my opinion, be entitled to proclaim a rare discovery; for he would add to our nosological lists, a local affection wholly inex- plicable in its origin, character and course. Let the successive features of the disease whose real nature I am endeavouring to disclose, be patiently considered in the light of adequate collateral knowledge, and I doubt not that similar views to my own will be adopted : only there must be exercised the requisite means and method, first, of inquiry, next of observation, and lastly of inference; for in this example the argument is some- times a cumulative one, and always the more emphatic when most widely based. I have referred chiefly to the pathological anatomy of Mycetoma, for evidence on which to found a right conception of its true nature; and now add that such evidence is but one link in a series of data, which, like a connected bond, renders indissoluble fact and conclusion. Want of space would prevent my here discussing at length the views and opinions of other observers; and I must be content with again urging the importance of seizing upon the typical features of this malady, duly discriminating and avoiding crude analogy. Were the whole history of Mycetoma unravelled, it would probably be as hard to follow as is that of the entozoic maladies ; and as a matter of fact, already the complaint has revealed an identity with organisms whose metamorphoses are, to all, still mysterious. I need not indicate, in detail, the points which seem the more obscure, but would here remark that the relation of the black and pale fungus-particles is yet but indifferently elucidated j it is not such as has been sometimes thought, on pathological evidence alone, and to future observers must be relegated the work of fully establishing the connection which undoubtedly exists between these organisms, as forms of one common growth. So far as I have advanced, it appears that the two are substitutionary, the one of the other; that the co-existence of sclerotia and malacotia is not to be anticipated ; and that a divergence of development takes place, under circumstances as yet unknown to me, at the commence- ment of growth, which is never restored until from the several fruit-products, the parent mould again springs forth outside the body of its temporary human host. In conclusion, despite the obscurities which yet attend some parts of the subject, I cannot but maintain upon these several grounds, both clinical and anatomical, my original thesis, namely that the foot-disease of India, in all its varieties, is a single and well-defined affection of a purely parasitic nature. I shall afterwards (Section V) endeavour to show that this parasite is of entojjhytic character; but I would here express my desire that due weight be allowed to the collected data which have already been submitted for consideration, because upon them alone might be based a determination of the kind of malady presented in the complaint under notice. Addendum.—In tlie comprehensive Nomenclature of Diseases, recently compiled under the auspices of the Eoyal College of Physicians of London (1869)—in the Appendix containing a list of ' Human parasites '— subdivision ' Entophytes'—is found tlie following identification :—Chionyphe Carteri (Berk.).