Fourth report of the Wellcome Tropical Research Laboratories at the Gordon Memorial College, Khartoum. Volume A, Medical / Andrew Balfour.

  • Balfour, Andrew.
Date:
1911
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Credit: Fourth report of the Wellcome Tropical Research Laboratories at the Gordon Memorial College, Khartoum. Volume A, Medical / Andrew Balfour. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    to me that their habitat might not be the blood but the skin, from which they may have been washed out by the first drop of blood. I had no means of telling which was the first film taken, but I noted that Horrocks and Howell, on several occasions, found the bodies in one slide out of several examined. On the other hand, this was by no means their invariable experience, while they once recovered the bodies from broth into which a piece of the liver of an ox or cow had been placed. This would appear effectually to dispose of the idea that they are derived from any part of the skin unless some contamination had occurred.* The same remark applies to their successful inoculations of rabbits. I asked Dr. Malouf to send me some more blood films and he forwarded ten, all unfortunately taken from one of the urticarial wheals, and numbered in the order in which they had been taken. In none of them were X bodies found. The previous blood films had been made from finger blood. I now sent Dr. Malouf two tubes of Nicolle's blood agar and several tubes containing the 1 per cent, sodium citrate solution employed by Horrocks and Howell, and requested him to inoculate these tubes with appropriate quantities of blood taken from the finger as at first. This he kindly did, and I incubated Attempts at the inoculated media at or about 22' C. The tubes were examined daily for five days, care Culture being taken to secure the blood sediment from the citrate tubes. Unfortunately, coccal or bacterial contamination, apparently of cutaneous origin, eventually made its appearance in every one of the tubes and at no time were any X bodies found. I tried hard to get the patient to visit the laboratories but in vain, and before Dr. Malouf could obtain other blood films or make other blood cultures she left for Kamlin on the Blue Nile. Hence, much to my regret, I was unable to pursue the case further or to confirm the findings of Horrocks and Howell in culture media or to repeat and extend their inoculation experiments. Although one cannot express any opinion on these curious bodies their occurrence in the Sudan is certainly interesting as is the fact that they were found in a case unassociated with fever but suffering from a recurrent or intermittent urticaria.f Mycetoma In the light of Brumpt's classification^ we are now in a position to say something more definite regarding the varieties of mycetoma encountered in the Sudan. Plate XXIII. shows four species of fungus grain namely Madurella mycetoma, Aspergillug bouffardi, Four varietie; Indiella somaliensis and an unclassified species. It is not intended to enter into any detailed account of these forms. Brumpt's excellent memoir deals fully with the subject, and the Sudan types, with one exception, appear to answer to his descriptions. In the case of the last named, the diagnosis is doubtful, for the specimen was received in spirit from Dr. Waterfield at Port Sudan and it was not possible to carry out cultivation experiments. The grains, however, were different to any hitherto seen, being of a rich brick-red colour, very hard and spherical in shape. Captain Archibald, who examined the specimen, found, on crushing the grains, * Note. Mr. George Buchanan, however, drew my attention to the fact that some of the forms were present on the slide beyond what one may call the commencement end of the blood film. This rather suggests that they may have been derived from the surface of the skin, especially as, in all probability, the slide was pressed down upon the finger in order to take up the drop, and not merely allowed to come in contact with the latter. t Since this paper was written, X bodies have been found by Major Ensor in blood films in a case of indefinite fever in the Military Hospital, Khartoum, and in smears of 'blood obtained by splenic puncture in a case of Kala-azar and sent to the Laboratories from Gallabat in the Kassala Province. A few were also encountered in a film of chick's blood made by a native attendant in the laboratories. None were found on his skin. ] Brumpt, B. (November 25, 1906), Les Mycetomes. Arch, dc Parasit., Vol. X. No. 4, and in Prici^ dc Parasitologie. Paris, 1910. Y