42 An Introduction to Medical Mycology 



1924 reported three cases of asthma in which the disease was due to the 

 spores of a wheat rust. He found positive reactions to an extract of the 

 organism, and acute attacks resulted on the inhalation of a small quantity 

 of the spores. Hansen found several species of Aspergillus and Penicillium 

 to be excitants capable of producing a paroxysm. Hopkins, Benham and 

 Kesten reported that in a case of asthma under their observation the at- 

 tacks occurred in locations in which mold spores were abundant. There 

 was cutaneous sensitivity to a strain of Alternaria present in the patient's 

 home, and attacks were provoked by inhalation of the extract. Feinberg, 

 Brown, and Conant, Wagner and Rackemann pointed out the importance 

 of molds in the patient's environment as a cause of asthma. They per- 

 formed many tests with the extracts of cultured air-borne fungi, and these 

 resulted in a high percentage of positive reactions. Wagner and Rackemann 

 noted that many patients with asthma obtained relief when kapok was 

 removed from their immediate environment. Fresh kapok did not cause 

 trouble; most of the reactions observed were produced by old material. 

 They found that the principle in commercial kapok active in skin tests 

 depends on the growth of molds in the kapok (vegetable) fibers. Wagner 

 and Rackemann also found that steam sterilization of both cotton and 

 kapok effectively changed the materials so that molds did not grow well 

 on them. Rowe recently stated that all patients with possible bronchial 

 asthma or allergic bronchitis should be tested with fungus extracts as well 

 as with other allergens. Waldbott and Ascher consider sensitivity to rust 

 and smut an important cause of seasonal allergy of the upper respiratory 

 tract. In two cases they were able to reproduce asthmatic attacks by in- 

 halation of rust. They consider the development of the attack during the 

 rust and smut season and strong reactions to their antigens to be reliable 

 features in diagnosis. 



Further detailed and controlled work in this subject appears to be 

 necessary in order to clarify the concepts. Few proved instances of true 

 bronchial allergy to fungi have been reported. 



2. HAY FEVER 



Correlation between the incidence of attacks of hay fever and prev- 

 alence of air-borne fungi has been recorded. Difficulty may be experi- 

 enced in ruling out air-borne pollens. 



BIBLIOGRAPHY 



Brown, G. T.: Hypersensitiveness t<> fungi, J. Allergy 7:455, 1936. 

 Cadham, F. T.: Asthma due to grain rusts, J. A. M. A. 83:27, 1924. 



