TEA-FACTORY COUGH 



working in tea- factories are occasionally observed to deteriorate 

 in their general health, losing flesh and becoming easily tired; at the 

 same time they develop a cough with muco-purulent expectoration. 

 The physical examination of the chest reveals nothing except 

 occasionally a few coarse rales. If these coolies are taken away 

 from the factory and sent to work in the fields, all the symptoms 

 slowly disappear. 



A similar affection may be observed in tea-tasters. Tea-lastcrs, 

 m order to judge of the quality of teas, not only taste infusions, but 

 frequently fill their hands with the leaves and bury their noses in 

 them, snuffing them up: in this way a certain amount of tea-dust 

 enters their nasal cavities, and with the tea-dust the micro- 

 organisms which are found in it. According to the researches of 

 one of us, tea and tea-dust in Ceylon contain: — 



1. Fungi of the genus Monilia constantly. 



2. Fungi of the genus Oidium occasionally. 



_ 3_. Fungi of the genus Aspergillus, Sterigmafocystis, and Peni- 

 cillium frequently. 



4. A peculiar streptococcus, somewhat different from S. pyogenes, 

 frequently. 



It is interesting to note that such germs are very rare or absent 

 m samples of tea examined in England. The same organisms m.ay 

 be found, m Ceylon, in nasal cavities of tea-tasters; in their ex- 

 pectoration the Monilia-like fungi are practically constant, the 

 streptococci very frequent, while Aspergillus and Penicillium fun^i 

 are rare. Guinea-pigs in whose nostrils tea-dust is daily insufflated 

 for months develop a broncho-alveolar monihasis. 



Bronchial Aspergillosis. 



Synonyms. — Broncho-alveolar aspergillosis, Aspergillar pseudo-tuberculosis, 

 Pneumomycosis of aspergillar origin. 



Definition. — A form of bronchitis and broncho-alveolitis due to fungi of 

 the germs AspergillusMicheli, 1729, and SterigmatocystisCi-Sumer, 1869 (p. 1026). 



Historical. — The condition has been studied by Virchow, Liclitheim, Dieula- 

 foy, Chantemesse, Widal, one of us, Wise, and others. 



Climatology. — The geographical distribution of the disease seems to be 

 cosmopolitan. It is very common in certain parts of France, and one of us has 

 seen two cases in the Balkans. In the tropics we have seen some cases in 

 Ceylon and Tropical Africa, and Wise has reported a case from British Guiana, 



iEtioIogy. — The condition is due to fungi of the genus Aspergillus Micheli 

 ,and Sterigmatocystis Cramer. It is common especially in people who have 

 to handle various grains, on which spores of those fungi are often found. In 

 France it is extremely frequent among pigeon-breeders {gaveurs de pigeons), 

 who fill their mouths with grain and blow it into the mouths of the pigeons. 

 -Of the two cases observed by us in the Balkans, one was apparentlj^ due to 

 Aspergillus fumigatus Fresenius, the other to Sterigmatocystis nigra Cramer. 



It is probable that the deleterious effects caused by the fungi are due not 

 only to a mechanical irritative action, but also to toxins secreted by the fungi. 



Morbid Anatomy. — The lungs, and occasionally the liver, kidneys, and other 

 organs, may show a type of pseudo-tuberculosis characterized by the presence 

 of numerous mycotic tubercular-like nodules. 



Symptomatology. — The presence of the fungi in the bronchi, when in smal 

 amount, may not give rise to any symptom. When the infection is heavy. 



