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rule,  takes  only  place  in  one  serosa.  What 
especially  characterises  this  period,  as  well 
as  the  following  ones,  is  the  hemoptysis, 
which  does  not  show  a  violent  character.  There 
are  mild,  sanguineous  discharges,  true  hemo- 
ptoic  sputa,  which  only  yield  to  iodides.  Such 
patients  do  not  show  thoracic  deformation 
and  are  well  built,  many  of  them  even  mus¬ 
cular.  They  are  only  pale  and  have  always  a 
foul  breath.  The  emaciation  only  appears  in 
the  last  periods  of  the  disease.  In  contrast 
with  this  appearance,  the  auscultation  re¬ 
veals  phenomena,  which  clearly  indicate  the 
pulmonary  lesions.  The  patients  complain  of 
vague  thoracic  pain.  Coughing  always 
accompanies  this  period,  but  has  nothing 
characteristical.  Sputum  is  scarce;  only  in 
few  cases  is  it  abundant  from  this  period, 
and,  moreover,  of  an  appearance  worth  remem¬ 
bering.  It  is  thick,  clear,  full  of  air,  and 
mixed  with  numerous  small  brick-coloured 
masses,  altogether  similar  in  aspect  to  the 
sputum  of  pneumonia;  we  miss,  however 
the  viscosity  of  the  latter.  Sometimes  a  light 
brown  colour  prevails  in  the  expectorations. 
In  about  twenty  of  the  examined  cases 
only  twice  was  ROGER’S  reaction  found  po¬ 
sitive  in  the  sputa,  which  teemed  with  Oi- 
dium  brasiliense. 
The  microbiological  research  of  KOCH’s 
bacillus,  the  cutireaction  and  the  ophthalmo¬ 
reaction  by  tuberculin  and  WASSERMANN’s 
leaction  are  negative.  The  reaction  for  Oi- 
dium  brasiliense  (fixation-and  intradermal 
reaction)  are  positive.  In  febrile  cases  the 
curve  is  not  characteristic.  Sometimes  the 
tracing  reminds  one  of  those  of  bacillary  tu¬ 
berculosis  in  the  period  of  fusion.  We  also 
observed  febrile  patients  with  night-sweats, 
insomnia,  palpitations  and  general  indispo¬ 
sition.  The  patient  complains,  in  the  morning, 
of  exhaustion  and  weakness  caused  by  want 
of  sleep.  There  may  be  dyspnoea  caused  by 
exertion.  The  examination  of  the  urine  ge¬ 
nerally  gives  no  positive  indications,  unless 
albumen  be  found.  The  presence  of  this 
substance  in  the  urine  makes  the  prognosis 
severe,  even  in  this  period. 
Careful  percussion  of  the  lungs  reveals 
an  incomplete  or  complete  dullness  in  varying 
regions.  The  initial  seat  of  the  lung  disease 
is  a  very  interesting  question. 
These  initial  foci  of  the  disease  are  lo¬ 
calised  in  the  apices,  in  the  middle,  in  the 
bases  or  in  different  places  of  the  lungs.  The 
localisation  in  the  apex  causes  a  dislocation 
of  KROENIG’s  lines  in  the  direction  of  the 
lesion.  The  limits  of  this  incomplete  dullness 
are  vague,  whatever  be  the  localisation. 
The  auscultation  reveals  an  appreciable 
modification  in  the  respiratory  phenomena. 
Harsh  inspiration,  faint  vesicular  murmur 
interrupted  inspiration,  sub-crepitant  ster- 
tores  are  constantly  observed  while-auscul¬ 
tating  the  foci  of  the  lesion. 
These  foci,  when  rather  intense,  may 
remind  one  of  “WEIL’s  disease”,  if  time  and 
some  symptoms  did  not  place  them  nearer  to 
“RENON’s  disease*'  (slow  form).  The  com¬ 
plete  sum  of  clinical  facts,  including  the  re¬ 
sults  of  treatment,  separate  it  not  only  from 
these  congestions,  but  also  from  “WOILLEZ’s 
disease”  of  rapid  cycle,  as  well  as  from  PO- 
TAlN’s  pleural  congestion.  The  clinical  syn¬ 
drome  accentuates  itself  in  this  direction, 
principally  when  the  disease  draws  towards 
the  second  period.  We  abstain  from  refer¬ 
ring  to  the  physical  signs,  we  might  call  in¬ 
direct,  because  the  tracheo-bronchial  adeno¬ 
pathy  and  the  pleurisy  were  already  dealt 
with  in  another  place. 
The  examination  of  the  digestive  system 
in  the  first  period  of  the  chronic  form  of 
the  manifest  disease  reveals,  frequently, 
slight  and  easily  cured  disturbances.  The 
spleen  may  increase  in  size,  the  liver  is  often 
painful.  The  circulatory  and  the  nervous  sys¬ 
tems  (central  and  peripheric)  show,  as  a  rule, 
normal  conditions. 
The  2nd  period  of  the  chronic  form  of 
the  manifest  disease  has  two  different  aspects. 
It  must  be  understood  that  we  do  not  esta¬ 
blish  mathematical  divisions  (always  very 
precarious  in  practice)  of  th  r  evolution  of  the 
pulmonary  lesion.  The  2nd  stage  of  the 
mycotic  pulmonary  lesions  is  divided  in 
