Seven patients exposed to the inhalation of synthetic fibres presented with various bronchopulmonary diseases, such as asthma, extrinsic allergic alveolitis, chronic bronchitis with bronchiectasis, spontaneous pneumothorax, and chronic pneumonia. The histological features are described and an attempt has been made to set up immunological techniques for the diagnosis. A series of histochemical techniques, based on textile chemistry, are proposed for the identification of the inclusions found in bronchopulmonary lesions. The results of the experimental production of the disease in guinea-pigs by the inhalation of synthetic fibre dusts are presented. The prognosis of these cases is good in the acute or recently established cases but is poor when widespread and irreversible fibrosis has set in. The authors consider that pulmonary disease due to inhaled particles is probably set off by an individual factor, possibly immunological.

Summary The widespread occurrence of spores of Penicillium frequentans in the air of a Portuguese cork factory was associated with the presence of precipilins against it in 3%, of exposed workers and a high incidence of radiological and functional changes in their lungs. Patients with suberosis gave positive reactions in skin tests with extracts of the fungus, and their inhalation as aerosols provoked characteristic symptoms. Cork particles were less numerous in the air and larger than P. frequenyansn spores, hut numbers were correlated with the incidence of precipilins in workers and it is suggested that they may have a role in sensitization and the pathology of the disease. However, P. frequentans seems to be the source of antigens in suherosis and accounts for the antigenicity of mouldy cork.

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The various phases of pulmonary aspergilloma, as described by Pimentel, are discussed and the results of an investigation of possible cases of this disease in patients whose condition made its presence likely are presented. A systematic search for Aspergillus precipitins in the sera of 136 patients was undertaken with A. fumigatus antigens. By this method two cases of pulmonary aspergilloma were diagnosed and later confirmed at operation. In a third patient the immunological diagnosis was negative but an aspergilloma was found at operation. This finding is discussed and a possible hypothesis is suggested. A pathological study of the surgical specimens is desirable to explain the false-negative Aspergillus precipitin reactions reported by various authors.

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