198 OASTELLANI. 



hours daily in rooms full of . tea dust and fluff and says that he often snuffs 

 various teas, putting a pinch of the tea in his nostrils. For sis months he has 

 complained of a cough with a certain amount of mucopurulent expectoration. No 

 fever. The examination of the chest reveals nothing. Microscopic examination of 

 the sputum for tubercle bacilli is negative. In fresh preparations a few branch- 

 ing mycelial tubes are visible; very few free spores. 



Treatment: Ordinary cough mixtures were useless; potassium iodide in large 

 doses cured the condition in four weeks. 



Case 2 (mild type). — Mr. S. A.. European planter; is compelled to remain for 

 a couple of hours daily in tlie tea factory. He consulted me in September, 1900, 

 and informed me that he was suffering from what the planters call "tea-factory 

 cough." He had mucopurulent expectoration; no fever; his general condition 

 was fairly good. The microscopic examination of the sputum for tubercle bacilli 

 was negative. Numerous spores and mycelial tubes of an oi'dium-like fungus were 

 present. 



Treatment: Potassium iodide in 1.0 gram (15 grains) doses four times daily 

 cured him in three weeks. 



Case 3 (severe iype) . — Mr. M., a planter. The sputum had been examined 

 many times for tubercle bacilli by his medical attendants with negative results. 

 When the patient arrived in Colombo he was extremely weak. He had serotine . 

 fever, bloody expectoration, fine crepitations and pleural rubbing on both sides. 

 I examined the sputum many times for tubercle bacilli with negative results. 

 Inoculation into guinea pigs was negative. Fresh preparations always showed 

 numerous spores and some mycelial (breads. Cultures were made from the 

 sputum on agar and on various sugar media. The only germ grown was a 

 hyphomycete which showed the same morphological characters as that present 

 in the fresh preparation, and a streptococus. The patient became gradually worse. 

 The cough was not relieved by guaiacol, duotol, nor by potassium iodide. He died 

 three weeks after arrival. 



Case J/. — Singhalese convict in Mahara jail, near Colombo. The symptoms of 

 his disease were at first obscure, and various diagnoses, including typhoid, malaria, 

 and phthisis, were suggested. The sputum was sent to me several times, but 

 tubercle bacilli were always absent. Instead, a saccharomyces and oi'dium-like 

 fungus were found. The patient was later transferred to the clinic for tropical 

 medicine "where I kept him under observation for two months. The cough slowly 

 decreased and finally stopped, the fever completely disappeared. His blood by 

 means of Widal's reaction was shown to contain agglutinins for the cultures of 

 the oidium-like fungus, and the saccharomyces. 



BACTERIOLOGICAL INVESTIGATION OP THE FUNGI FOUND IN THE FOUR CASES. 



In four cases I plated from the expectorations and grew the hypho- 

 mycetes. In the case from the Mahara jail, as I briefly stated, two 

 fungi were present — a saccharomyces and an o'idium — in the other three 

 cases only oi'dium-like fungi were observed. 



