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Infection of the lungs by Friedlander's bacillus has received scant study. A fairly comprehensive review of the English and French literature and of standard works 1 reveals few references to this organism. Sisson and Thompson2 published an account of 33 cases from the literature, and added four of their own. The present article presents the results of a study of eighteen cases of pulmonary infection by Friedlander' s bacillus.

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A case of pulmonary infection caused by Mycobacterium kansasii occurring in New Zealand is described. The diagnosis of atypical mycobacterial infection was first suspected because of the histological features. These findings are compared with those of other authors and are shown to differ in detail.

Summary (1) In only six of 58 cases of pulmonary tuberculosis complicating glandular tuberculosis is a good prognosis given. (2) Factors apparently having some bearing on the prognosis are operative interference of the glandular lesion, the age of the patient at the onset of the pulmonary lesion and the type of the lung lesion. (3) The possibility that, in cases where the causal organism of the pulmonary lesion is human, the lung infection may be exogenous in origin, is discussed.

SummaryIn more than half the cases studied, the authors have observed a discrepancy between the bacteriological examination of the sputum and that of the secretion obtained aseptically from the bronchi.They criticize the practice of performing routine susceptibility tests to antibiotics on the sputum.They attract attention on the high rate of incidence of sterile bronchial smears, which witnesses the resistance of bronchial mucosa towards infection. They analyse the microbiological flora found in various clinical groups.They advise to obtain secretion through a bronchoscope whenever the evolution of a lung infection is not conform to criteria established on clinical grounds.

It should be evident from this review that the early treatment and eradication of acute and subacute disease entities within the respiratory system, is positively necessary if we are to expect to obviate their serious sequelae. The best treatment is, therefore, preventive, and little may be expected from medical measures after these chronic infections have become evident. It is the main and primary object of this discussion of chronic nontuberculous infections of the lungs to stress the urgent necessity of diagnosing the earliest etiologic pathologic states, which lead otherwise to an incurable and serious disease, and, do all in our power to promote, if possible, their prompt and thorough eradication.

The number of interesting cases reported under the names of pseudotuberculosis cladothrichica, pseudotuberculosis streptothrichica, actinomycosis atypica pseudotuberculosa, together with the attempts of Grasperini, Levy and his pupils, Lachner-Sandoval and Neukirch, to establish the botanical position of the so-called streptothrices on morphological and biological grounds, justifies the report of another similar case. It must be stated in the beginning that owing to the absence of cultures and animal inoculations exact species identification is impossible, yet from the morphology and tinctorial peculiarities, as well as the nature of the lesions produced by the organism, it is highly probable that we have to deal with a pathogenic actinomyces similar to the ones described by Eppinger, Aoyama and Miyamoto, W. Gr. MacCallum, Schabad, and others.

Opportunist mycobacterial diseases of the lung are reviewed and the epidemiology of the infections discussed. The course of disease based on radiological changes is described in 27 patients. Seventeen patients (63 per cent) had distinctive radiographic changes; 5 showed very distinctive lesions consisting of groups of 1 cm homogeneous shadows around translucent zones with line shadows radiating from each lesion, while 12 had relatively small but thick-walled cavities. In 10 patients (37 per cent) the appearances were non-specific; 5 had large relatively thin-walled cavities in shrunken upper lobes (an appearance often considered pathognomonic of opportunist mycobacterial disease), and another 5 had shrunken upper lobes with only small cavities or dilated bronchi within them.

Although the portal of entry of Cryptococcus neoformans is believed to be the lungs, viable airborne particles of C neoformans small enough to reach the alveoli have not been observed previously in nature. Airborne particles from pigeon excreta were sampled with an Andersen sampler and a venturi scrubber. When sampled in a 6.2-liter laboratory air chamber and in a church belfry, approximately 0.01960.3396 of viable, airborne C neoformans existed in particles with diameters between 1 [i and 5.5 jx. The demonstration of particles compatible with alveolar deposition supports the hypothesis that cryptococcosis may originate as a pulmonary infection.

The usefulness of anaerobic culture of percutaneous transtracheal aspirates has been evaluated in 91 untreated patients with various pulmonary conditions. Bacteriologic results were correl...

If the earliest symptoms and signs of consumption were as easily definable and as pathognomonic of the disease as those manifested in the later stages, it might be easily diagnosed in its incipiency. But, unfortunately, this has not been the fact. In a great many cases the onset is sudden or occurs during the progress of a severe cold or bronchial catarrh, or following in the wake of some other acute disease. Frequently, however, it is ushered in by symptoms which point to no particular form of disease, and it is this class of cases that is the most puzzling until we find pronounced symptoms pointing to lung infection. There are often certain symptoms of a general constitutional impairment, insufficient in themselves to render a diagnosis possible, but which do point to a definite disease if properly studied. There are many cases occurring in active practice in which a positive

The relationship of pneumoconiosis and lung infection has been the subject of much study and investigation in the past twenty-five years. Although most of these studies have concerned themselves with silicosis and tuberculosis, other pneumoconioses and other lung infections have been scrutinized more recently as to their possible relationship but with no relationship observed. I shall therefore limit this discussion largely to the silicosis-tuberculosis combination. Nontuberculous infections, particularly the pneumonias, have been shown by numerous clinical studies and animal investigations to be no more prevalent with any of the pneumoconioses than in the population generally. Even when the patient has definite silicosis, increasing data suggest that it does not cause an increased susceptibility to pneumonia or other nontuberculous infection.1Moreover, the benign pneumoconioses, such as the siderosis of welders and grinders, have in my experience not been responsible for more pulmonary infections of any kind, including tuberculosis.2A

IT is generally appreciated that a lung infection of adult rats is common to most laboratory rat colonies, and it is not unusual for up to 75 per cent of a colony to be infected. In recent years the disease has been given various names, but it is usually described now as a pleuro-pneumonia-like organism infection. This merely means that it is an infectious catarrh caused by these organisms. However, no specific organisms have been isolated which could be held responsible for the disease. Normally the infection only appears in the older rats, but the very young animals may also succumb to it, probably being infected by their mothers.

Excerpt Since Weichselbaum's1work in 1886, it has been known that the micro-organism described by Friedlander2in 1882-3, can cause pulmonary diseasesui generis. Friedlander's conception, however, t...

Excerpt Nasal accessory sinus disease is one of the most important clinical subjects that we have to consider today. It is more frequently overlooked and more inadequately treated than almost any o...

To the Editor: —It was with interest that I read inThe Journal, July 19, 1919, an article entitled "Type I Pneumococcus Among Porto Rican Laborers." The summary states that "Porto Ricans under favorable conditions are susceptible to lung infection by the Type I pneumococcus. The disease pursues a typical course, accompanied by a bacteremia in about the same proportion as among white persons." Do the authors of the article wish to exclude all Porto Ricans from the white race, or may we take it as a lack of information? Mr. Fred K. Fleagle, dean of the University of Porto Rico some years ago, who has lived in this island for a number of years, has said: "The island of Porto Rico, covering an area of 3,500 square miles, had in 1910 a total population of 1,118,012. The population is as follows: pure white persons, 65.5 per cent.; mulattoes, 30