DIATHERMY EXTIRPATION OF THE PHARYNGEAL TONSILS
Authors: D. McKenzie
Journal: BMJ (1929)

500 C. It grows well on ordinary sugar and glucose agar.It does not grow oni Sabouraud's maltose agar at any temperature.Oni agar and glucose agar the growth is a pale yellowish tint..It also grows in broth and on potato.It liquefies gelatin witlh tho production of a greenish tint.Many sugars are fermented by i4.In raffinose, acid and gas are produced.In inulin-negative.In dtilcite-negative.In maltose, acid and gas are produced.In mannite, acid and gas are produced.In litmus milk-alkaline, no coagulation.In salicin-negative.In glucose, acid and gas are produced.In saccharose, acid and gas are produced.In lactose, acid and gas are produced.Scales from seborrhoeic scalps have been planted ouit upon 8 per cent.glucose agar and incubated at 270 C., anid this organism has been found in association with others.implantations after scarification have been made upon the skiin, using the spore of Malassez as a control.At the end of fifty-six hours no lesions have appeared in the case of Dr.Benedck's culture, whilst the usual follicular papular lesion has occurred with the implantation of the spore of Malassez.Dr. Benedek's organism appears to be a sporing bacillus, and unrelated to any yeast forms.Beniedek's claims are clearly too fantastic to gain any wido acceptance.He dispenses entirely with seborrhoea a-nd w-itlh DaIrier's kerosis.In his opinion tlhero is nio hlicrieditary element in seborrlloea, only an inifection witl a pathogenie fun-gus-tlhat is to say, theie is no pi-e-existent soil on which the fungus will thrive, but a soil that is miiade by the toxinis of his fungus.Furtlher, from the observations made in the laboratory of St. Jolhn's Hospital, it would appear that the organiism is niot a yeast at all.Even if it were an ascormycete, as lie claims, there exists no known pathogenic aseomycete, the only possible near relation to a true yeast being the blastom-ces of Gilchrist.Finllyl, he states that he regards the spore of Malassez as a harmnless sapropliyto.In all tho funigous inifectionis of the epidermis that I have mentioned at the beginniinc of this paper the proof of the causal relationship of the fungius in eaclh case is not the fact that it can be cultivated, but that it can be easily seen in the scales produiced bIl the disease.In the stained scale of pityriasis capitis or sebor- rhlocie derimatitis one can alway-s see thle spore of Malassez, buit never any other fungus.This fact, I think, is the stroncest, possible evidenico in favour of its etiological signlficanlce.SUMMARY AND CONCLUSIONS.From dlanidruff a funigus can be cultivated wlicil, wlhen imiiplanited on the skin, l)roduces a condition clinlically in- distinguiislhable from seborrhoeic dermatitis.It call bo recovered from the artificial lesion by culture, and may bo seeni in a scraping of the lesion.Tho funigus appears to be a species of the monilia type of fungus, though differinig, as deoniioistrated by MacLeod, from other kniowni patho- geniic species of this genus in definite respects.I believe it to b)e the spore of Malassez for the followinig reasons:1.It resembles the spore of Malassez morphologically.2. Thie spore of Malassez is always found in dandruff, and is the only fungus that can be seen iniside the scales.It may tllerefore be regarded as the cause of pityriasis capitis, for the same reason that lIicrosporon lurfutr is accrpted as the cause of pitvriasis versicolor.Pitvriasis capitis or dandruff has been regarded, since Inna, as the starting point of seborrhoeic dermatitis,.anid the breeding grounid of the disease.The spore of Malassez is therefore concerned in the production of seborrhoeic dermatitis.3. Thle cultivated fungus is capabule of accurately repro- duciha.the disease, not merely a crusted or scaly lesion but on-which is primarily follicular, papular, and ulti- mately squamouls, andI whlich, in many cases, cannot be distin,g-uished from those already present.