CHAPTER VIII. 

 RHINOSCLEROMA. ' 



IN Austria, Hungary, Italy, and some parts of Ger- 

 many there sometimes occurs a peculiar disease of the 

 anterior nares, characterized by the occurrence of circum- 

 scribed tumors, known as rhinoscleroma. The tumor- 

 masses are somewhat flattened, isolated or coalescent, 

 grow with great slowness, and recur if excised. The dis- 

 ease commences in the mucous membrane and the adjoin- 

 ing skin, and spreads to the skin in the neighborhood by 

 a slow invasion, involving the upper lip, jaw, hard palate, 

 and sometimes the pharynx. The growths are without 

 evidences of inflammation, do not ulcerate, and consist 

 microscopically of infiltration of the papilla and corium 

 of the skin, with round cells which change in part to 

 fibrillar tissue. The tumors possess a well-developed 

 lymph-vascular system. Sometimes the cells undergo 

 hyaline degeneration. 



In these little tumors the researches of Von Frisch dis- 

 covered little bacilli much resembling both in morphol- 

 ogy and vegetation the pneumo-bacilli of Friedlander, 

 and, like them, surrounded by capsules. The only 

 marked difference between the so-called bacillus of rhi- 

 noscleroma and the Bacillus pneumonise of Friedlander 

 is that the former stains well by Gram's method, while 

 the latter does not, and that the former is rather more 

 distinctly rod-shaped than the latter, and more often 

 shows its capsule in culture-media. 



The bacillus can easily be cultivated, and in all media 

 resembles the bacillus of Friedlander too closely to be 

 distinguished from it. Even when inoculated into animals 

 the bacillus behaves much like Friedlander' s bacillus. 



Inoculation has, so far, failed to produce the disease 

 either in men or in the lower animals. 



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