. American practice of surgery ; a complete system of the science and art of surgery . ced mycetomatous foot or hand, an oily, greasy surface is shown, thesoft tissues have lost their anatomical character and are blended into a tumefied,pultaceous, nondescript mass, and the bones are rarefied and partially absorbed. MYCETOMA. 63 Each distinct focus consists of a cyst-like cavity, from a mere speck to aslarge as a walnut in size, filled with the concretions which are typical of the dis-ease, surrounded with a semi-purulent, oily fluid, which may or may not bemalodorous. The typical concretions
. American practice of surgery ; a complete system of the science and art of surgery . ced mycetomatous foot or hand, an oily, greasy surface is shown, thesoft tissues have lost their anatomical character and are blended into a tumefied,pultaceous, nondescript mass, and the bones are rarefied and partially absorbed. MYCETOMA. 63 Each distinct focus consists of a cyst-like cavity, from a mere speck to aslarge as a walnut in size, filled with the concretions which are typical of the dis-ease, surrounded with a semi-purulent, oily fluid, which may or may not bemalodorous. The typical concretions in the ivJdte, pale, or ochroid variety of thedisease consist of small yellowish or pink granules, held together by inspissatedgrease in masses which have been compared to fish roe. Similar masses, but ofa black color, exist in the melanoid mycetoma. It is the recognition of these roe-like masses in the discharge which usually establishes the diagnosis. In rareinstances the granular concretions are absent and the sinuses and cysts are filledwith the oleaginous, purulent fluid Fig. 22.—Mycetoma of About Two Years Standing. (After Legrain.) Symptoms and Course.—As already stated, a large proportion of the pa-tients will refer the beginning of the disease to a fester from the prick of a thornor to some other slight injury. When this is not the case and the disease appearsto the patient to have arisen spontaneously, the first symptoms are a localizedtenderness, soon followed by a local tumefaction. A nodule is formed at theaffected spot, varying in size from a pea to a small marble, and surrounded by amore or less diffuse inflammation (see Fig. 22). The overlying skin graduallybecomes inflamed, thickened, and adherent. The ball of the thumb or of thegreat toe, or the pads of areolar tissue and fat along the bases of the fingers andtoes, are favorite initial seats of the disease (Bocarro). The progress of the in-flammation and the infiltration of new tissue on sole or dor
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
