Page:Tropical Diseases.djvu/931

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MYCETOMA
875

made out; others are not so apparent, their position being indicated and, at the same time, concealed by a bunch of pale, flabby, fungating, and but slightly vascular granulations. In the latter the orifice may be hard to find. Once the probe is got to enter, the instrument readily passes to a considerable depth, even to the bone; in advanced cases it can be carried through the softened tissues with the greatest ease in almost any direction, and without causing much pain or hæmorrhage.

Fig. 206.—Section of a Madura foot. (T. R. Lewis.)

The discharge issuing from the sinuses differs in amount in different cases, and from time to time in the same case; whether profuse or scanty, it always exhibits the same oily, mucoid, slightly purulent appearance, and may stink abominably. With a very few exceptions it contains either the grey or the black grains already referred to; rarely similar bodies of a reddish or pink colour.

To the touch the swollen foot feels somewhat elastic, and does not readily pit on pressure. The sensibility of the skin is preserved. Although complained of in some instances, severe pain is rarely a prominent feature. The principal complaint is of inconvenience from the bulk and weight of the mass,