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November 1969

Hypersensitivity Disease of the Lungs Due to Fungi and Organic Dusts.

Author Affiliations

Wailuku, Hawaii

Arch Intern Med. 1969;124(5):637. doi:10.1001/archinte.1969.00300210119019

The name of Pepys with a London dateline conjures up images of Restoration intrigue and compulsive clandestine chronicle keeping. I could find no hint of such romantic excursions in this monograph, but there is an unmistakable quality of scholarship.

This slender book tackles two fascinating aspects of a group of "new diseases" of the lungs: disorders related to pulmonary hypersensitivity to inhaled organic dusts. The major sections are devoted to Aspergillus fumigatus (bronchopulmonary aspergillus hypersensitivity) and farmer's lung disease (moldy hay—perhaps Micropolyspora faeni hypersensitivity) causing "extrinsic allergic alveolitis."

The author focuses upon these disturbances as examples of allergic responsiveness to antigenic stimuli occurring at different geographical sites in the respiratory tree. Aspergillus hypersensitivity involves bronchial and peribronchial areas with asthma and eosinophilia, while farmer's lung is characterized by alveolitis with gas diffusion problems.

Other extrinsic allergic alveolitides include bagassosis (moldy bagasse); mushroom worker's lung (mushroom compost); fog-fever in cattle (moldy

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