RHINOSCLEROMA 285 



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 or gelatin is said to be less distinct, and the 

 growth on potatoes is more transparent and may show small 

 bubbles of gas ; but 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 would appear 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 

 conjunctivas of guinea-pigs. The relation of the rhinoscleroma 

 organism to that of Friedlander is, however, still a matter of 

 doubt, and the matter has been further complicated by the fact 

 that a bacillus possessing closely similar characters has been 

 found to be very frequently present in ozoena, and is often 

 known as the bacillus ozcence. The last-mentioned organism is 

 said to have more active fermentative powers. From what has 

 been stated it will be seen that a number of organisms closely 

 allied in their morphological characters, have been found in the 

 nasal cavity in healthy or diseased conditions. There is no 

 doubt that rhinoscleroma is a specific disease with well-marked 

 characters and it is quite possible that one member of this group 

 of organisms may be the causal agent, though indistinguishable 

 from others by culture tests. There is, however, a tendency on 

 the part of recent investigators to consider the "bacillus of 

 rhinoscleroma " to be identical with the pneumobacillus and its 

 presence in the affected tissues to represent merely a secondary 

 invasion. The subject is one on which more light is still 

 required. 



