22 
ted  and  burning  skin.  The  dyspnea  becomes 
more  accentuated.  Coughing  grows  into¬ 
lerable  by  night  and  day.  The  tongue  is  coated. 
The  liver  is  painful  on  pressure,  exceeding 
frequently  the  costal  cartilage.  The  spleen  is 
not  always  palpable.  We  observe  anorexia  and 
sometimes  diarrhea,  but  no  night-sweats.  The 
pulse  becomes  soft  and  the  pulsations  un¬ 
countable. 
The  effusion  in  other  serosae  is  evident 
and  sometimes  voluminous.  The  urine  con¬ 
tains  albumen.  The  adynamia  is  extreme. 
Cachexia  appears  and  death  follows,  if  a 
saving  treatment  is  not  adopted. 
The  whole  process  varies  from  30  to  50 
days. 
The  ophtalmo-and  cutireactions  exclude 
KOCH’s  bacillus,  as  well  as  the  researches 
in  the  sputum,  made  with  strict  and  exac¬ 
ting  methods. 
The  research  for  Oidium  brasiliense 
gives  positive  results. 
In  one  of  our  cases  we  interfered  in  the 
second  stage  of  the  acute  evolution,  adminis¬ 
tering  only  2  gr.  of  iodide  of  potash,  by  gastric 
way. 
This  therapeutical  reserve  was  imposed 
by  the  severe  conditions  of  the  patient,  whom 
the  rapid  evolution  of  the  disease  had  evi¬ 
dently  reduced  to  the  extreme  of  organic 
distress. 
The  symptomatical  therapeutics  had  al¬ 
ready  been  exhausted,  before  the  diagnosis 
of  pulmonary  mycosis,  caused  by  Oïdium 
brasiliense,  was  made.  As  soon  as  this  diag¬ 
nosis  was  confirmed,  the  treatment  with  io¬ 
dides  was  called  for,  as  a  decisive  and  heroical 
medication. 
As  to  its  results,  thy  are  illustrated  by 
the  behavior  of  the  patient  who,  considering 
himself  cured,  resigned,  of  his  own  free  will, 
the  rest  of  the  leave,  granted  for  treatment, 
and  reassumed  his  place  in  the  ranks,  depar¬ 
ting,  in  mil litary  service,  for  a  place  near 
Bello  Horizonte. 
In  these  cases  we  observe,  besides  the 
severe  pulmonary  lesions,  other  ones  of  equal 
importance  in  other  organs. 
The  whole  organism  is  affected.  In  the 
second  stage  the  disease  is  manifested  by 
attack  on  the  whole  line.  In  the  acute  form 
there  is  septicemia.  We  already  isolated  the 
fungus  from  human  blood. 
The  oidiomycotic  septicemia  in  man  is 
similar  to  that  observed  in  animals. 
Much  before  this  interesting  verification, 
which  throws  a  strong  light  on  the  clinical 
forms  of  the  human  disease,  the  facts  obser¬ 
ved  in  our  laboratory,  made  us  already  ex¬ 
pect  its  possible  occurrence  in  man. 
In  the  saguin  (Callithrix  jacchus  L. 
1766)  death  follows  within  22  hours,  accom¬ 
panied  regularly  by  polyserositis  and  genera¬ 
lisation  of  mycotic  infection. 
Besides  this  hyperacute  form  there 
is  another  one,  also  generalized  but  secon¬ 
dary,  in  some  marmosets  (Hapale penicillata) 
and,  principally,  in  rabbits.  Here  the  simple 
acute  evolution  often  lasts  6  days,  contras¬ 
ting  with  the  chronic  forms  of  the  experi¬ 
mental  disease,  with  protracted  evolution  and 
duration  varying  from  several  months  (3  or 
4)  to  more  than  a  year  (cavernous  proces¬ 
ses  in  the  rabbit). 
The  acute  form  of  the  disease  in  man 
does  not  exactly  represent  a  form  of  pure 
septicemia,  as  happens  in  the  saguin.  In  the 
marmoset  it  is  a  septicemia  from  the  begin¬ 
ning,  without  predilection  for  any  organ,  or, 
more  exactly,  adapting  itself  to  all  organs, 
from  the  first  manifestations. 
In  the  acute  form  of  the  human  disease 
we  observe  the  same  as  in  rabbits,  after 
intraperitoneal  injection.  It  attacks  the  lungs 
firstly  and  intensely;  the  fungus,  however,  may 
be  isolated  from  other  organs  and  even 
from  the  blood.  We  find  similar  facts  in 
other  microbian  infections  of  man,  as,  for 
instance,  in  highly  febrile  bacillary  pulmona¬ 
ry  tuberculosis,  either  chronic  or  acute. 
I 
Chronic  forms. 
The  first  period  of  the  “manifest  disea¬ 
se”  (chronic  form)  may  include,  besides 
the  fundamental  pulmonary  symptoms,  the 
above  described  serositis.  Effusion  here,  as  a 
