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.
945/972 page 935
![surface. In the more superficial oues some part of the wall is want- in-:-, so that the cavities look like mere round holes pf various depths; hut in the deeper cavities a regular tunnel, more generally straight than curved, serves as the channel of communication. The diameter of these passages is sometimes equal to that of the cavi- ties themselves. In the recent state the sinuses of the soft parts are often plugged up by superficial collections of the fungus; but when cleared out they are found to lead down to the tunnelled pas- sages, or into the rounded holes—the peculiar loci of the fungus. [Any one, says Dr. Carter, who is acquainted with the fungus disease could not mistake it, when tolerably advanced, for ordinary caries; the size of the foot, its globular form, and the number and appearance of the sinuses, being the chief diagnostic characters; to which may be added the absence of a corresponding degree of con- stitutional disturbance, pain, or hectic fever, and the patient is generally of a scrofulous or syphilitic taint. But the character of the discharge is commonly a certain test of the nature of the disease: the fungus particles may usually be detected- with the aid of a lens. In the black variety a single glance will be sufficient, and in the pale and soft (which have been well compared to mustard or poppy seeds) their appearance is hardly less characteristic] The fungus has only once been seen afTecting the hand (Cole- brook). [Dr. Carter says, the hands are also, though less com- monly, attacked with the disease. The hand so affected is much swollen, of a dark color, and studded with numerous sinuses; the form of the swelling is more or less globular. The whole hand may be implicated, or one side or part only, in which latter case the projecting fingers seem to be imbedded, being themselves, gen- erally, free, and the palm is usually flat or even convex. The dis- ease seldom extends beyond the wrist, and its whole look at first sight resembles a long-standing scrofulous affection. The disease begins sometimes in one of the fingers.] Description of Incipient Fungus Disease.—The lesion has the appear- ance of an elongated flattened tumor, the rounded surface of which is marked with white patches, and presents several circular depressed spots of one-third to one-half inch, or more, in diameter. The super- ficial dark layer of cuticle is cast off, leaving a very regular circular white surface, the centre of which presents a depression, closed at the bottom by a brownish layer, very thin in the middle. It was found on section that a small cavity existed beneath this depressed spot, or a tubular prolongation was detected running down through the remaining thickened cuticle and cutis into the subcutaneous cel- lular tissue, where it was not difficult to find the fungus particles, pink or yellowish-colored, and also in the cavity above-named, in](https://iiif.wellcomecollection.org/image/b21196606_sciencepracticeo00aitk_0945.jp2/full/800%2C/0/default.jpg)
