33 
the  lung  must  be  put  aside,  on  account  of 
the  initial  and  rudimentary  knowledge  of 
mycology  at  that  time.  In  the  systematic  my- 
cology,  however,  the  place  was  filled, 
although  the  description  of  BENNEPs 
fungus  may  fit  equally  well  an  Endomyces,  a 
Mycoderma  as  and  Oidium.  Not  less  doubtful 
is  the  origin  of  the  parasite,  wich,  in  want 
of  positive  notions,  may  have  come  from  the 
mouth,  bronchia  or  lung. 
The  pulmonary  actinomycosis  (Discomy- 
ces),  either  primitive  (rare)  or  of  cervicofa¬ 
cial  propagation  (common),  has  a  definite 
aspect  in  practice  and  in  microscopy.  The 
diagnosis  in  most  cases  imposes  itself.  To 
the  integrity  of  the  apices,  the  predilection 
for  the  bases,  the  rarity  of  hemoptysis,  the 
usual  absence  of  adenopathy  (primitive  cases), 
the  remarkable  tendency  to  propagation 
(liver  and  spleen)  are  added  the  cultures, 
smears  and  inoculations  for  ex:luding  deci¬ 
sively  the  pulmonary  actinomycosis;  this  ex¬ 
clusion  becomes  still  easier,  when  the  pul¬ 
monary  follow  on  cervicofacial  lesions. 
Clinical  experience,  however,  registers  cases, 
in  which  the  differential  diagnosis  was  diffi¬ 
cult. 
As  all  the  chronic  lung  affections,  they 
resemble  much  tuberculosis,  pulmonary  scle¬ 
rosis  and  chronic  bronchitis.  The  apical  lo¬ 
calisation,  the  hemoptyses,  ihe  physical  signs 
of  sclerosis  or  ulceration  in  the  lungs,  be¬ 
side  the  combination  of  nocturnal  sweats 
and  irregular  fever,  might  often  lead  the 
practitioner  in  error,  if  the  fetid  purulent  ex¬ 
pectoration  without  KOCH’s  bacillus,  without 
Oidium  brasiliense  and  with  characteristical 
elements  of  actinomycosis,  did  not  help  to 
establish  a  speedy  and  certain  diagnosis. 
The  laboratory  gives  the  final  decision. 
ROGER  &  BORY  presented,  in  1909, 
an  observation  of  pulmonary  mycosis,  caused 
by  a  fungus,  which,  in  their  opinion,  was  an 
Oospora  (pulmonalis). 
The  observation  is  complete:  post-mor¬ 
tem,  anatomo-pathological  and  clinical  exa¬ 
minations,  were  made.  The  lesions  consisted 
of  a  classical  pseudo-lobar  broncho-pneumo¬ 
nia  and  of  a  series  of  cavernae.  The  fungus 
was  well  studied. 
According  to  the  description  of  the  au- 
thois,  the  parasite  is  a  “microsiphonated  hy- 
phomycete  of  the  genus  Discomyces,  and, 
therefore,  all  confusion  is  excluded,  even  ii 
the  fungus  is  erroneously  considered  as 
not  pertaining  to  this  genus,  but  to  the 
genus  Oospora  (of  WALROTH  1883). 
The  parasite  of  thrush,  the  Endomyces 
albicans ,  is,  of  many  other  fungi,  the  one 
which  causes  probably  ihe  greatest  confusi¬ 
on.  The  characterisation  of  this  fungus  is 
today  relatively  easy,  especially  after  the 
studies  of  VUILLE1VUN.  This  fungus  is  ex¬ 
ceptionally  localised  in  the  lungs.  It  general¬ 
ly  occupies  the  mouth,  the  upper  air  tubes 
or  even  parts  of  the  digestive  tract.  Some 
authois,  however,  deny  the  autonomy  of  a 
pulmonary  mycosis,  caused  by  Endomvces 
albicans. 
It  is  the  parasite  of  depauperated  con¬ 
valescents  of  tvphoid  fever,  of  patients 
with  diabetes,  tuberculosis  etc.  Living  as  a 
saprophyte  in  the  buccal  cavity,  it  may,  when 
conditions  of  organic  inferiority  are  given, 
reach  the  higher  respiratory  tubes  and  even, 
according  to  some  rare  observations,  the 
lung. 
REBATTU  &  GARIN  found,  in  1911, 
only  5  observations  of  pulmonary  mycosis 
caused  by  Endomyces  albicans. 
GARIN,  in  1914,  made  a  profound 
study  of  all  the  affections  caused  by  this 
fungus  and  discussed  the  question  of  the 
cultural  forms  of  the  Endomyces.  There  is  a 
certain  likeness  between  the  evolution  of 
these  forms  and  that  of  Oidium  brasiliense , 
but  the  morphology  differs.  In  the  clinical 
post-typhoid  pulmonary  forms  GARIN  finds 
only  yeasts  in  the  sputum.  We  found  also  fi¬ 
laments  in  oidiosis.  We  repeat  that  the 
yeastforms  of  the  Oidium  brasiliense  express 
a  well  defined  fact,  the  struggle  of  the  para¬ 
site,  be  it  caused  by  the  poverty  of  a  cultu¬ 
ral  medium  (old  cultures,  GORODKOWA’s 
medium  and  tissues),  or  the  adaptation  to  a 
fresh  medium  (recent  form  in  fresh  sowings). 
