25 
ted.  Respiration  takes  place  in  a  very  reduced 
space.  The  dyspnoea,  which  ought  to  be 
violent,  may  appear  reduced  or  almost  absent, 
if  the  organism  has  time  to  adapt  itself. 
In  the  hepatized  regions  the  dullness  is  com¬ 
plete.  The  duplicity  of  the  lesion  makes  a 
comparative  percussion  difficult.  The  intensi¬ 
ty  of  the  changes  are,  however,  recognized 
by  comparison  with  unaffected  regions. 
The  thoracic  vibrations  are  increased. 
There  is  bronchophony,  tubal  and  so¬ 
metimes  pseudo-cavitary  breathing.  In  se¬ 
veral  places  of  the  injured  lung,  auscultation 
reveals  large  foci  of  crepitant  stertores.  The 
sputa  are  abundant,  with  the  appearance 
already  described  (always  with  blood).  Per¬ 
manent  coughing.  In  the  2nd  variety  of  the 
3rd  period,  leading  to  cavern-formation,  the 
symptoms  vary  according  to  the  size  of  the 
caverns.  The  cavitary  signs  depend  on  the 
size  of  the  cavern:  they  are  the  “bruit  du 
pot  fêlé”  on  percussion,  gargling,  cavernous 
breathing,  pectoriloquia  and  even  amphoric 
sound  on  auscultation,  in  one  or  both  lungs. 
The  lungs  show,  furthermore,  various  zones  of 
fusion,  and,  in  some  places,  reduced  foci  of 
crepitant  stertores. 
The  general  condition  of  the  patient  in 
the  3rd  period  is  very  bad.  The  paleness 
is  intense  and  emaciation  extreme.  Facies 
with  hollow  cheeks,  zygomatic  arches  pro¬ 
minent  eyes  sunk  and  without  life,  viscous 
sweat  on  face  and  hands,  Diminished  physiog¬ 
nomic  mobility.  Permanent  coughing.  The 
temperature  rarely  shows  the  character  of 
hectic  fever;  as  a  rule,  it  follows  no  certain 
type.  It  drags  on  within  the  lowest  de¬ 
grees  of  fever  and  falls  again  to  normal 
state;  one  day  it  rises,  to  fall  the  next  and 
to  disappear  for  a  long  time.  Expectoration 
is  abundant.  Hemopfoical  sputa  are  persis¬ 
tent.  The  serous  cavities  may  contain  abun¬ 
dant  fluid.  There  is  polyserositis. 
There  are  symptoms  of  pericarditis  with 
effusion;  also  symptoms  of  pleural  effusion 
and  ascites.  Dyspnoea  variable.  Liver  swol¬ 
len  and  painful.  Spleenvclume  increased. 
Percentage  of  hemoglobin  and  red  bloodcor- 
puscles  distinctly  lowered.  Tachycardia.  Pul¬ 
se  weak,  arrhythmical.  Urines  scarce,  red. 
with  or  without  albumen  and  with  positive 
diazo-reaction  (MARCELLO  LIBANIO).  Pro¬ 
nounced  adynamia.  The  patient  in  this  ma¬ 
rasmus  may  feel  hungry'.  In  spite  of  this 
gloomy  picture  we  succeeded  in  curing  in¬ 
dividuals  with  apical  caverns  in  both  the 
lungs,  by  exclusive  treatment  with  iodides. 
One  step  further  we  reach  the  oidiomy- 
cotic  cachexia,  with  oedemas,  diarrhea, 
muscular  weakness,  cyanosis,  trophic  lesions. 
The  sputum  is  almost  entirely  swallowed. 
Accentuated  dyspnoea,  intellectual  torpor.  In 
the  last  periods  of  the  disease  the  animals 
show  the  same  picture.  The  “ Alouatta ”  falls 
victim  to  a  profound  marasmus.  The  orga- 
nical  decadence  is  extraordinary.  We  already 
described  this  disease  in  animals  in  another 
chapter.  After  this  ressuming  of  the  clinical 
features  there  remains  for  completing  this 
chapter,  to  discuss  the  sputum  and  the 
parasite  in  the  tissues. 
Sputum. 
When  a  sputum,  suspected  of  con¬ 
taining  KOCH's  bacillus,  is  examined,  as  a 
rule,  a  contrast  stain  is  made  by  metyllene 
blue  after  the  action  of  acid  and  alcohol  and 
the  washing  in  water. 
The  Oidium  brasiliense,  is  neither  acid- 
nor  alcohol-fast,  hence,  undoubtedly,  it  only 
appears  in  blue  colour.  This  was  how  we 
first  saw  the  Oidium  brasiliense  in  the  sputum 
of  a  woman.  The  sputum  may  be  exami¬ 
ned  immediately,  without  preparation  or  ho¬ 
mogenization.  In  the  latter  case  the  method 
of  FONTES  must  be  preferred.  In  smears 
of  sputum,  well  made  by  platinum-wire-loop 
(in  increasing  concentric  circles  and  very 
thin  layers)  the  fungus  is  seen  in  two  forms: 
the  yeast  form  (common)  and  the  mycelian 
form.  We  give  a  photography  of  a  smear  of 
sputum,  stained  by  ZIEHL-NEELSEN’s 
method.  We  see  a  true  agglomeration  of 
elliptical  yeast  forms,  but  do  not  observe 
any  trace  of  fine  structure.  Besides  this  ellip¬ 
tical  form,  there  is  an  oval  one.  They  are 
