404 DISEASES OF UNCERTAIN ETIOLOGY 



DISEASES OF UNKNOWN ^.TIOLOGY AFFECTING THE 



RESPIRATORY SYSTEM. 



(1) TROPICAL HAY FEVER (Rhinitis spastica vasomotoria). 



Adults are attacked. There are violent fits of sneezing, lasting 

 from two minutes to two hours. There is an excess of nasal secretion. 



Lachrymation, conjunctivae injected, eyelids swollen. 



These attacks may recur the same day or over several weeks. 



There may be accompanying asthmatical symptoms. 



The mucous membrane over the turbinate bones becomes swollen 

 and may cause nasal obstruction. 



A spray of cocaine, i per cent., and adrenalin locallv is useful. 



Atropine and strychnine pills may be tried. 



A clTange of climate may clear up the malady. 



(2) GANGOSA (Rhino-pharyngitis mutilans). 

 DEFINITION. 



An ulcerative condition affecting the palate, nose, pharynx, larynx 

 and skin, destroying cartilage and bone, thus producing permanent 

 deformity. 



DISTRIBUTION. 



It appears to be endemic in the Batanes Islands, where some hold 

 it to be the early stage of leprosy. 



It is also found in the Ladrone Islands, Guam, Caroline Islands, 

 Fiji, Murray Island, Panama, British Guiana, Ceylon, Nevis, 

 Dominica and Italy. 



Dr. Anton claims that it is a blastomycosis due to a specific parasite, 

 the Cryptococcus mutilans. This requires confirmation. 



SYMPTOMATOLOGY. 



A sore throat is complained of, caused by a nodule on the palate 

 or at the back of the pharynx, or on the posterior pillar of the fauces. 

 This becomes a superficial ulcer covered by a greyish slough. 



This ulcer spreads, destroying the adjacent tissue, soft and hard 

 alike, so that in time the skin falls in allowing the nasal and buccal 

 cavities to form one aperture. 



It may then afifect the face without or the larynx within. 



Vision may be destroyed. The odour given ofif is most offensive . 



Ulcers may appear on other parts of the skin which is uncovered 

 by clothing. 



Ugly deformities are caused by the scarring and contraction. 



A chronic osteitis may set in simulating that of syphilis. 



