BACILLUS OF RHINOSCLEROMA. 285 



mucous membrane of the pharynx, larynx, or upper part of the 

 trachea. It is scarcely ever met with in this country, but is 

 of not very uncommon occurrence on the Continent, especially 

 in Austria. In the granulation tissue of the nodules there are 

 to be found numerous round and rather large cells, which have 

 peculiar characters and are often known as the cells of Mikulicz. 

 Their protoplasm contains a collection of somewhat gelatinous 

 material which may fill the cell and push the nucleus to the side. 

 Within these cells there is present a characteristic bacillus, 

 occurring in little clumps or masses chiefly in the gelatinous 

 material. A few bacilli also lie free in the lymphatic spaces 

 around. This organism was first observed by Frisch, and is now 

 known as the bacillus of rhinoscleroma. The bacilli have the 

 form of short oval rods, which, when lying separately, can be 

 seen to possess a distinct capsule, and which in all their micro- 

 scopical characters correspond closely with Friedlander's pneumo- 

 bacillus. They are usually present in the lesions in a state of 

 purity. It was at first stated that they could be stained by 

 Gram's method, but more recent observations show that like 

 Friedlander's organism they lose the stain. 



From the affected tissues this bacillus can be easily cultivated 

 by the ordinary methods. In the characters of its growth in the 

 various culture media it presents a close similarity to that of the 

 pneumobacillus, as it also does in its fermentative action in milk 

 and sugar-containing fluids. The nail-like appearance of the 

 growth on gelatin is said to be less distinct, and the growth on 

 potatoes is more transparent and may show small bubbles of 

 gas ; otherwise it resembles the pneumobacillus. It is doubtful 

 whether any distinct line of difference can be drawn between 

 the two organisms so far as their microscopical and cultural 

 characters are concerned. 



The evidence that the organisms described are the cause of 

 this disease consists in their constant presence and their special 

 relation to the affected tissues, as already described. From these 

 facts alone it is highly probable that they are the active agents 

 in the production of the lesions. Experimental inoculation has 

 thrown little light on the subject, though one observer has 

 described the production of nodules on the conjunctivae of 

 guinea-pigs. The relation of the rhinoscleroma organism to 

 that of Friedlander is, however, still a matter of doubt, and the 



