J. _BRONCHIAL TUBES AND LUNGS.— In bronchitic actinomycosis the affection is less severe in winter than in summer, which is the contrary of what is observed in ordinary bronchitis. It can be classi fied in three groups: (1)lesions of chronic bronchitis, (2) miliary actinomycosis, and (3) cases with broncho-pneumonia and abscesses. The lower lobe is attacked more frequently than the upper; the op-' posite is the case in tuberculosis.
Review of 14 recorded eases of actino mycosis of the lung. The only 2 which recovered were those in which radical operations, with resection of four or five ribs, and cauterization of the diseased cavity in the lung were carried out. All those that were simply incised and drained ended fatally. The infection of the lung may be secondary to either cervico-facial or pharyngeo-cesophageal actinomycosis, or it may be primary, either through the bronchi or from an external wound. There are three forms clinically: (1) the pulmonary, with in sidious onset, going on to induration of a large area of lung, generally in the sub clavicular or postero-lateral regions, the apices being usually free; (2) the bron chial, with a diffuse bronchial catarrh, and fcetid muco-purulent expectoration, containing the fungus; (3) the pleural.
with effusion; the co-existence of pleural effusion with retraction of some part of the thoracic parietes—due to fibrous changes in the lung—is pathognomonic. Another pathognomonic symptom is the presence of a swelling in the wall of the thorax where it has been invaded by the fungus, along with shrinking of the lung causing retraction of the thoracic walls; later on this softens and becomes sub fluctuating without the formation of large abscesses. Puncture obtains a fluid containing fragments of fungus. Death may occur after months or years, ac cording to the varying invasion of other organs by the disease; in one case of rapid diffusion of the fungus death oc curred in twenty-four days. Parascan dole (Brit. Med. Jour., from Clinica Mod., Nov. 7, 1900).