Madsen

MADSEN Thorvald (born in 1870), the famous Danish bacteriologist. He graduated from the faculties of law and medicine, the latter in Copenhagen in 1893. Since 1902 he has served as director of the Danish state serum institute, and since 1909 as a member of the Supreme Council of Health. Since 1921 he has been president of the hygiene committee of the League of Nations. In addition, from the same year he is chairman of the Permanent Standard Commission and of the International Serological Conferences (in London, Paris, Frankfurt am Main, Copenhagen). M. is the author of about 100 printed works, which almost without exception relate to immunobiology, where he mainly develops questions of serodiagnosis and serotherapy. M. and Arrhenius were the first to attempt to interpret the phenomena of immunity from the standpoint of physical chemistry (see Immunity). The works of M. have and have had important practical significance in the matter of preparing and standardizing immun preparations, as well as in clarifying and internationally agreeing upon serological methods of investigation. Madsen participated in the fundamental "Handbuch der Technik u. Methodik der Immunitatsforschung" (edited by R. Kraus and C. Levaditi, Vol. I-II, Jena, 1908-11). The majority of Madsen's works have been published in the journals: Annales de l'Institut Pasteur, Zentralblatt fur Bakteriologie, Zeitschrift fur Hygiene and others. 'MADURA FOOT [Madura foot, mycetoma Madurae, mycetoma pedis, fungus foot of India (Carter), podelkoma, pied de Cochin, morbus tuberculosus pedis, ulcus grave, peri-cal, endemic transformation of the bones of the foot (Carter), Madura disease], a local chronic infectious disease caused by one of the numerous species (over 15) of mold fungi (Discomyces Madurae, Nocardia, Streptothrix Freeri and others). These fungi are obtained in pure cultures and are pathogenic under experimental conditions for rabbits, guinea pigs, monkeys, and dogs. In man, depending on the genus of the fungus, in one case yellowish and whitish-gray grains resembling fish roe are found in the pus, in others - reddish and dark brown grains. The yellow and black varieties have been studied in most detail. Usually the fungi enter the body through damaged skin or a wound surface, often together with splinters and thorns of plants. The disease is endemic among natives mainly in India (the city of Madura), as well as almost all of Africa, Turkey, Syria, Madagascar, the Philippine Islands, Central America, Mexico, and in isolated cases in Europe (Italy, Romania, Greece). As a rule, the foot is affected, less often the knee, upper extremities, hands, abdomen, hairy part of the head, the area of the elbow bend and the jaw, and extremely rarely the skin of other areas of the body. The disease usually begins to develop from the sole with signs of swelling, edema, and redness, then small nodular tumors and intensely itching nodes, the size of a cherry pit, appear, which exhibit an irresistible tendency to slow but progressive growth and increase. On the background of these nodes, blisters form. Subject to softening, the dense granulation nodes (or "gummas") located in the thickness of the skin open outward through multiple fistulous tracts, from which serous or yellowish serous-purulent fluid containing a large amount of characteristic parasite grains, 2x3 mm in size, is secreted. With the prolonged existence of the process, the whole foot is horribly disfigured, acquiring a shapeless, clumsy appearance (elephantiasis), while the shin, on the contrary, atrophies. Severe pain on prolonged walking. Sometimes swelling of regional lymph nodes is observed, as well as damage to bones and periosteum. Madura foot does not show a tendency to spontaneous healing. Internal organs are never involved in the process. Sometimes patients die of exhaustion and cachexia after 10-20 years. According to Chalmers and Archibald, cases of Madura foot can be divided into 3 groups: a) true Madura foot, characterized by the formation of fistulous tracts and the presence of a large amount of grains in the discharge; b) paramycetoma, in the purulent contents of which grains are found in scant quantity or are absent altogether, and c) false mycetoma, which clinically manifests in the form of sarcomatous or epitheliomatous growths resembling Madura foot in appearance, but with the absence of grains in the discharge. The disease is most often observed in the age group from 21 to 40 years. Bocarro's (Vosaggio) statistics show that the largest contingent of patients falls on farmers (91%) and persons who mostly walk barefoot (9%). Diagnosis of Madura foot, despite the characteristic clinical picture, can be established accurately only on the basis of laboratory data. Madura foot differs from actinomycosis by a more chronic course (decades) and a purely local character of the lesion. Treatment. Internal remedies do not exert a therapeutic effect. Hot baths sometimes alleviate suffering. Temporary improvement is given by X-ray rays; radical is surgical intervention - excision of fresh nodes or amputation of the foot in chronic cases.