Volume 1
The science and practice of medicine / By William Aitken ... From the 4th London ed., with additions, by Meredith Clymer.
- William Aitken
- Date:
- 1866
Licence: Public Domain Mark
Credit: The science and practice of medicine / By William Aitken ... From the 4th London ed., with additions, by Meredith Clymer. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
944/972 page 934
![foot, peculiar to certain parts of the Bombay Presidency, were recorded by Assistant-Surgeon Bazunjee Rustomjee, in the fifth vol. (N. S.), p. 230, of the Transactions of the Medical and Physical So- ciety of Bombay, and which Dr. Carter considers are the most fully and carefully recorded instances of the ' fungus disease' which had been published at the time Dr. Carter wrote his report. Most of the cases belong to the second form of fungus described in the text; and practically the disease is regarded in India as a species of caries. [Some idea of the frequency of the disease may be gained from the fact that individual observers in India reckon their cases by the score. Dr. Carter says that one person sent him particulars of seventy-five cases he had treated, and that even in Bombay, where the disease is not endemic, a year seldom passes without three or four cases being seen at the hospital. Other noteworthy features are : it has mostly a single local manifestation; it is much more frequent in men, and during the middle periods of life, and commonest amongst the agricultural class; it is not hereditary, nor peculiar to any diathesis (Carter).] Symptoms.—In the first variety the general form of the foot is oval, being much enlarged about the ankle and over the instep. On either side of the ankle-joint, on the dorsum of the foot near the toes, likewise on the sole, are numerous small soft swellings or tubercles, as large as a pea or marble, having pouting, puck- ered apertures, leading to fistulous canals; and the skin surrounding these apertures appears lighter in color than elsewhere. (See speci- mens in the Museum of the Army Medical School at Eetley.) The canals sometimes lead directly to the bone ; and a discolored glairy fluid, which exudes from the canal, sometimes carries with it a few black gritty particles. The toes are distorted and displaced upwards, and the muscles of the calf of the the leg atrophied. Such a con- dition has been known to exist for more than twelve years ; and the natural course of the disease is fatal [from exhaustion of the vital powers]. The external characters of the other forms are similar to those already described. The changes produced in the bones, as shown by maceration, are of such a kind that a cursory examination of them at once suggests the conclusion that some organic agency has been at work to pro- duce the changes. The cancellated tissue becomes the seat of cavities more or less spherical, and sometimes most perfectly so. These cavities vary in size from little more than that of a pin's head to that of a round bullet; and the walls of the cavities are formed by open cancellous tissue. From being in close juxtapo- sition, they frequently open into each other, producing large vaulted gaps or spaces; and not only so, but every cavity, large or small, has an open communication, directly or indirectly, with the external](https://iiif.wellcomecollection.org/image/b21196606_sciencepracticeo00aitk_0944.jp2/full/800%2C/0/default.jpg)
