PIITHISIS FLORIDA, OR GALLOPING CONSUMPTION.—In acute, or galloping, consumption there is usually the clinical picture of an ordinary lobar pneumonia —with suddenness of onset and chill rapidly followed by fever. pain in the side, and cough with rusty sputum. There are the ordinary physical signs of increased tissue-density. The crisis fails to appear at the expected time, and with the breaking down of the broncho-pneu monic area, which occurs in the latter half of the second week, there is a profuse muco-purulent expectoration. which may excite suspicion of the real nature of the trouble. An examination of the sputum shows numerous bacilli. and the clinical picture now becomes one characteristic of pus-absorption. There are chills, fever, and drenching sweats; the temperature becomes irregu lar and shows the usual evening rise; the pulse is weak and frequent, the respira tions rapid, and there may be marked dyspnma. The hectic state soon super venes, and the patient dies from gradual exhaustion.
Upon opening tubercular abscesses many years ago, before antiseptic pre cautions were observed, infection by pus cocci took place, a mixed infection re sulted, and the clinical picture domi nating the case, that which gave it its similarity to consumption, came on only after communication with the air had been established, or, in other words, after secondary infection had occurred.
It is the pus-coccus which is largely re sponsible for the picture long recognized as consumption, and not the bacillus of tuberculosis. Eliminate the result pro duced by its action in chronic ulcera tive phthisis, and that disease would never have been known by the familiar name which it now bears. Pulmonary tuberculosis of the chronic ulcerative type should be looked upon in almost every instance as a dual disease, one in which several factors, chiefly two, are simultaneously at work, and in which the bacillus of tuberculosis and the pus coccus play the relative parts; the one, the bacillus, through its coagulation necrosis acting as the gate-opener to the other, the pus-coccus, the peptonizing invader which liquefies the tissues and produces that poison which, when ab sorbed, gives rise to chills, fever, sweats, emaciation, and the consumptive ap pearance.