17 
does  not  succeed  with  animals,  inoculated 
by  the  peritoneum.  Death  here  is  the  rule. 
The  post-mortem  examination  reveals,  besides 
great  emaciation,  a  diffuse  serous  peritonitis. 
In  man. 
Clinical  aspect 
The  human  oidiomycosis  shows  a  group 
of  symptoms  identical  with  that  of  tuber¬ 
culosis  caused  by  KOCH’s  bacillus.  Now  that 
differential  diagnosis  is  possible,  we  may  say 
that  the  disease  is  a  tuberculosis  without 
KOCH’s  bacillus  and  with  Oidium  bras  iliense. 
Many  cases  of  o:diomycosis,  in  want  of  ano¬ 
ther  name,  have  undoubtedly  been  hidden 
under  the  label  t  :herculosis  or  syphilis. 
As  a  rule,  the  general  condition  of  the 
patient  is  bad.  Even  in  the  first  periods,  the 
facies  is  pale,  dejected,  emaciated.  The  mu¬ 
cosae  have  a  sallow  aspect,  due  to  the 
poverty  in  red  blood  corpuscles  and  hemo¬ 
globin  and  rarely  missed  in  the  clinical  pic¬ 
ture.  At  the  beginning  anorexia  is  rare.  We 
saw  fatal  cases,  where  bulimia  succeeded  to 
absolute  anorexia.  Remissions  are  transitory. 
Fatal  relapse  succeeds  almost  always  to  the 
glimmering  hope  of  salvation. 
Improvements  are  casual  (as  seen  in 
many  human  mycoses)  and  their  cause  is  not 
explained  exactly  by  either  clinical  observa¬ 
tion  or  microscopy.  The  physical  power  of 
the  individual  sinks  remarkably.  In  the  last 
periods  of  the  disease,  the  emaciation  of  the 
patient  is  extreme.  We  do  not  know  of  any 
other  disease  surpassing  it  in  this  respect. 
From  the  begining  the  patients  generally 
have  a  fetid  and  nauseous  breath.  This  bad 
smell  has  nothing  characteristical  ;  however, 
it  is  distinguished  from  that  of  pulmonary 
or  bronchial  gangrene  (type  PIRQUET).  The 
group  of  symptoms  also  separates  the  Oidio¬ 
mycosis  from  the  curable  fetid  bronchitis 
(LASÉGUE).  The  latter  is,  in  preference, 
the  disease  of  week  convalescents,  whose 
organic  resistance  has  suffered  from  some 
debilitating  and  fatal  influence.  This  fetidness 
disappears,  when  the  patient  is  recovering 
from  oidiosis.  For  clinical  orientation  we 
admit  two  principal  periods  in  the  disease  : 
lo  —  the  period  of  incubation. 
2o  -  the  period  of  manifest  disease. 
This  includes  acute  and  chronic  forms, 
the  latter  wich  3  periods  according  to  the 
evolutionary  stages  of  the  parasite  in  the 
lung.  Here  we  shall  study  also  the  inflamma¬ 
tion  of  serosae  and  finally  the  oidiomycotu 
cachexia. 
The  first  period  represents  a  silent  stru- 
gle.  The  parasite  penetrates  into  the  orga¬ 
nism  through  the  affected  or  healthy  tonsils 
or  mucosae  (in  monkeys  Alouatta  we  obtai¬ 
ned  penetration  of  the  parasite  through  the 
bucco-nasal  mucosa).  If  the  defense  of  the 
epithelia  fails,  the  fungus  establishes  itself  by 
preference  in  the  lymphatic  system  for  a  new 
attack.  From  our  patients  we  did  not  gather 
much  information  about  this  mucoso-amygda- 
lo-ganglionic  period.  They  are,  as  a  rule,  in- 
educated  and  do  not  inform  anything  of 
value  for  the  history  of  the  disease  ;  what  we 
know  and  found  out  about  this  period  of 
the  disease  is  due  exclusively  to  post-mortem 
examinations  and  to  experiments.  Only  to 
the  results  of  those  do  we  owe  the  under¬ 
standing  of  this  period  of  the  disease;  then 
and  only  then  could  we  obtain  a  lasting 
result  by  accompanying  carefully  the  clinical 
syndromes.  This  initial  period  of  the  disease 
is  one  of  silent  struggle,  where,  as  a  rule, 
it  is  not  recognized.  The  adenitis  of  the 
neck,  the  tracheo-bronchial  glands  and  those 
of  the  mesentery  are  mute  and  painless  le¬ 
sions  of  the  lymph  nodules.  The  hypertrophy 
which  here  may  attain  extreme  dimensions, 
prejudicial  to  the  neighbouring  oigans  and 
even  to  the  life  of  the  patient  (compression 
of  the  pneumogastric  nerves,  the  trachea, 
etc.),  has  not,  however,  the  ostentatious 
aspect  of  the  violent  inflammatory  and 
transitory  forms.  In  oidiomycosis  there  exists 
only  hypertrophy  varying  in  size  and  aspect. 
This  stage,  if  not  passing  entirely  unper¬ 
ceived,  is  rarelv  remembred  by  the  patient 
giving  the  history  of  the  disease.  By  percus¬ 
sion  the  practitioner  obtains  some  informa¬ 
tion,  helped  by  careful  examination  of  the 
