. A practical treatise on medical diagnosis for students and physicians . in the food or drink, and gainsentrance to the body through abrasions in the mouth or a decayed tooth,or is inspired into the lungs. Israel, Ponfick, and Bostrom have givenus the greatest amount of information in regard to this parasite. It wasdiscovered in 1845, in human beings, by B. von Langenbeck, and in1877, in cattle, by Bollinger. At the seat of invasion a slowly growing, slightly painful tumordevelops. Bones are affected as well as soft tissues. These become swol-len and suppurate, the fungus being at all times o
. A practical treatise on medical diagnosis for students and physicians . in the food or drink, and gainsentrance to the body through abrasions in the mouth or a decayed tooth,or is inspired into the lungs. Israel, Ponfick, and Bostrom have givenus the greatest amount of information in regard to this parasite. It wasdiscovered in 1845, in human beings, by B. von Langenbeck, and in1877, in cattle, by Bollinger. At the seat of invasion a slowly growing, slightly painful tumordevelops. Bones are affected as well as soft tissues. These become swol-len and suppurate, the fungus being at all times obtainable. The fungous ACTINOMYCOSIS. 809 masses appear to the unaided eye as particles of yellow sand, and aregreasy to the touch. Pulmonic Form. Actinomycosis of the lung may be divided into threestages; a latent stage, when the lung proper is affected ; an active stage,when extension to the pleura and chest-wall takes place; and a final orchronic stage, when perforation and the formation of a thoracic fistulaoccur and the adjoining organs become affected. Fig. Case of actinomycosis. The symptoms of the first stage are those of chronic bronchial catarrh,with later the occurrence of the physical signs of consolidation, especiallyin the mam miliary and axillary regions of the chest, in the middle zoneof the thorax. The apices and bases are rarely affected primarily. The symptoms of the second stage are those of pleurisy, with adhesions,and with or without effusion. At this time the disease may extend down-ward to the liver and peritoneum, or the pericardium may become and pain accompany these processes. On physical examination, inaddition to the signs of the pulmonary and pleural conditions abovementioned, swelling of the thoracic wall will be observed, not unlike thatdue to an empyema which is about to perforate. The swelling, which isat first dense, and hard, and red, becomes softer in small areas, and mavfluctuate. Fluid, which is mucopurulent and contai
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