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

  • Carter, H. V. (Henry Vandyke), 1831-1897.
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 Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Case 5.—Prom Kutch. A Hindoo, act. 27, shepherd : thin and weak, suffers little pain. The right foot is irregularly swollen in both dorsal and plantar aspects, which present numerous small openings, giving exit to a scanty, thin, discoloured fluid. The disease began fifteen months before admission, as a small hard swelling in the sole, with little pain: two months afterwards an opening formed, and black granules, like seeds, began to come out from time to time. Amputation of the leg was performed on November 12, 18G1, and the patient made a fair recovery. The foot is swollen; the toes much extended. The skin has not changed in colour. At the root of the toes, on the dorsum, are three or four small apertures filled w'ith black particles, one or two being situated towards the margin of the foot, and others on the sole at the front. On section it is seen that a considerable growth of the dark sclerotia (which vary in size from that of a pin’s head to a split pea) has taken place in the soft parts imme- diately beneath the apertures just described, that is, in the subcutaneous tissue on the dorsum of the foot, at the root of the toes and in the sole, along its whole extent. It does not appear that either the tarsal or metatarsal bones have been attacked ; the osseous tissue is healthy. Minute examination of these various parts was made with results mentioned below. Case G.—An elderly man, resident at Satara, Deccan, a vakil (lawyer) by profession, applied to me on account of a long-standing sore, situated between the toes of one of his feet; it had been tliere upwards of fifteen years, and not unfrequently there came away from it small, hard, black particles. I found that the cavity of the ulcer extended inwards some distance; there was very little discharge; the black particles were characteristic fragments of the smaller kind described in this work. The interest of this case centered in the long duration and slight progress of the growth ; it is possible that a sore may have existed long prior to the introduction of fungus-spores, but 1 have no evidence bearing on this point. Case 7.—J. J. Hospital, Bombay, ISGl. A Mussulman, ast. 27, sailor, a native of Bunder Abbas, in the Persian Gulf. The left foot began to enlarge ten years since after a fall ; the swelling now presents all the characters of mycetoma ; black particles may be picked out of the sinuses, and when examined microscopically exhibit sprouting cells and beaded fibres. This man suffers no pain or constitutional disturbance; and, finding no other remedy proposed than amputation, declines to submit to operation. Cases 8 and 9.—Mycetoma of the Hand.—Two specimens were forwarded to me in May, 1862, by Mr Siidasew Ilemraj, medical attendant of the Eao of Kutch; both were examples of the black variety, and figures of them are given in Plate III. Case S.—Oookerdo, a Hindoo cultivator, aged about 70, a native and resident of a village situated to the north of Bhooj, has disease of the ring finger of his right hand. Says that about a year and a half ago a small swelling about the size of a pea formed on the palmar aspect of the right ring finger; this swelling began slowly to increase, and in about a year it attained the size of a nutmeg, became painful, burst and gave exit to thin sanious matter mixed with dark-coloured, granular, seed-like particles. After this, the swelling began to extend all over the finger, now and then bursting and discharging matters as above described, and tlius the finger has attained its present size. When examined in Bombay the specimen presented the following characters:—It appears to have been somewhat swollen; the palmar surface opposite the middle phalanx presents four or five rounded openings, in which may be seen imbedded the black fungus-bodies; one or two such apertures are placed at the side, and all are of characteristic appearance, being circular, clean cut, and narrowest at bottom; occasionally they are blended together. On making section through these places, it is found that the disease does not pass deeper than the sheath of the flexor tendons, but extends along them for some distance ; the soft parts in front being occupied by cavities two or three lines in diameter, which are filled with the fungus-growth, and which are connected together by small tunnels or canals passing from one to the other, beneath the cutaneous surface; so that these parts are riddled, as it were, by the disease, while aU the other textures of the finger seem to be sound. There are no pink stains visible; and further examination elicited no new features of the disease, either general or minute. Case 9.—The hand (right side) is from a low-caste Hindoo female, native of Wagur; she is unable to give