. Annals of surgery . f left lumbar region. markedly. The gain in weight has been pronounced. The tumors,however, have shown no signs of diminishing in size. In fact, theyhave again become as large as they were before the toxins were attending physician again tried the erysipelas toxins, but thepain caused by the injection caused him to desist. Case LXXIL—L. M. Tiffany, Baltimore. (I am indebted toDr. Tiffany for the following heretofore unreported case.) Male, 240 JOHN RUHRAH. aged thirty-six; first seen in consultation with Dr. Bosley in that time there was a collection of p
. Annals of surgery . f left lumbar region. markedly. The gain in weight has been pronounced. The tumors,however, have shown no signs of diminishing in size. In fact, theyhave again become as large as they were before the toxins were attending physician again tried the erysipelas toxins, but thepain caused by the injection caused him to desist. Case LXXIL—L. M. Tiffany, Baltimore. (I am indebted toDr. Tiffany for the following heretofore unreported case.) Male, 240 JOHN RUHRAH. aged thirty-six; first seen in consultation with Dr. Bosley in that time there was a collection of pus in the right iliac fossaextending above the crest of the ilium behind. A free opening inthe right lumbar region was followed by a copious evacuation of took place rapidly. Early in 1899 suppuration was againdetected in the left lumbar region, which was freely opened. Thewound did not heal completely, sinuses remaining. One month laterintestinal contents appeared in the discharges of the sinuses. Addi-. FiG. 2.—Actinomycosis of face, jaw, and orbit. tional sinuses appeared in the neighborhood of the incision. Impair-ment of motion and sensation was present in both legs, but moremarked on the left side. The patient died of malnutrition fourmonths later. The streptothrix actinomycotica was demonstrated onseveral occasions. The accompanying figures (i and 2) show this and one ofDr. Tiffanys earlier cases. Errata.—On page 419 of the October (1899) numberthere is a statement to the effect that the first case of the dis- ACTINOMYCOSIS IN MAN. 241 ease to be recognized in England was that of Dr. is an error, as Dr. Hartley insisted that his case was oneof tuberculosis. The honor belongs to Dr. T. D. Acland, whoheld that the case was one of actinomycosis, and proved it byhis demonstrations. I am indebted to Dr. Acland for theabove correction. The literature concerning this case will befound below. ADDITIONAL LITERATURE. Walker, J. E. : Actinomycosis, Me
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