1892 DISEASES OF THE RESPIRATORY ORGANS 



symptoms of bronchitis with muco-purulent, and occasionally bloody, expec- 

 toration are present, and in severe cases the patient may have hectic 

 temperature, with sweatings and great wasting. 



Diagnosis. — This is based on finding the fungus. It is to be noted that in 

 the sputum as a rule only mycelial threads are found, and cultivations are 

 therefore necessary. 



Prognosis. — Mild cases often recover, but in severe cases with bloody ex- 

 pectoration the prognosis is bad. 



Treatment. — A change of climate and, when the condition is brought about 

 by certain occupations, a change of occupation is very beneficial. Potassium 

 iodide (gr. xv. to xx.) may be administered. 



Bronchial Penicilliosis. 



One of us has observed cases of bronchitis and broncho-alveoUtis due to 

 fungi of the genus Penicillium in the tropics and one in the Balcanic zone. The 

 fungus isolated from the last case was P. crustaceum Linnaeus. 



The symptomatology, diagnosis, and treatment are the same as in Bronchial 

 Aspergillosis . 



Bronchial Mucormycosis. 



Cases of bronchitis caused by fungi of the genus Mucor Micheli, 1729, 

 Lichtheimia Vuillemin, 1904, Rhizomucor Lucet and Costantin, 1900, Rhizopus 

 Ehrenberg, 1820, may be met with, but are of rare occurrence. The sympto- 

 matology is the same as that of Bronchial Aspergillosis. We have seen a case 

 in the Balcanic zone due to Mucor mucedo Linnaeus. For description of the 

 fungi see p. 972. 



Bronchial Sporotrichosis. 



A few cases have been described of a bronchitis due to fungi of the genus 

 Sporotrichum Link, 1809. 



Undetermined Bronchomycosis. 



One of us has described cases of bronchomycosis due to fungi which have no I 

 yet been classed . 



PULMONARY NOCARDIASIS. 



Synonyms. — Pulmonary streptothromycosis, Pseudo- tuberculosis. 

 Definition. — Pulmonary nocardiasis is an infection of the lung, and usually 



other organs, with a species of the fungal genus Nocardia Toni and Trevisan, 

 in which the signs and symptoms more or less resemble those of phthisis. ' 



Historical. — In 1897 Flexner described this disease, isolating the causal 

 organism, which he named Streptothrix pseudotuherculosa Flexner, 1897. In 

 the same year Buchholz found a similar case in Berlin, and Scheele and 

 Petruschky described a third at the Wiesbaden Congress. In 1902 Birt and 

 Leishman met with a case in a soldier, and since then similar cases have been 

 recorded by Foulerton, by Roger, Bory, and Sartory in 1909, and have been 

 seen by ourselves in Ceylon, the Balcanic zone, and the Anglo-Egyptian Sudan, 

 and by Pi j per in South Africa. 



Climatology. — The disease occurs in the Temperate and Tropical Zones, in 

 the New and the Old World, and may therefore be widespread. 



-ffitiology. — The causal agents appear to be varying species of nocardia — 

 thus, for example, Flexner's case was caused by Nocardia pseudotuherculosa 

 (Flexner, 1897) ; Birt and Leishman's case by Nocardia leishmani Chalmers and 

 Christopherson, 191 6; Scheele and Petruschky 's case by N. gedanensis (Scheele 

 and Petruschky, 1897); and Foulerton's organism by N. foulertoni Chalmers 

 and Christopherson, 1916; while Roger, Bory, and Sartory's organism is 

 called A^. pulmonalis (Roger, Bory, and Sartory, 1909). Very commonly these 

 fungi are present in the sputum as acid-fast rods which may or may not appear 

 in branched form. When present in rod-like forms they give rise to an appear- 



