i65 



turned to ulceration. Often in an early stage softening takes 

 place in the centre of the nodule, and it is transformed into a 

 small abscess. 



Hollow ulcers are rarely found. Generally profound 

 granulation rises from the bottom of the ulcer resulting in the 

 formation of polypous growth, in the same manner as in the 

 skin. The anatomical picture depends on the degree and age 

 of the affection. In slight cases single nodules are hidden 

 behind the turbinated bones ; in another case the whole meatus is 

 filled up with granulation tissue, or the mucous membrane is 

 extensively destroyed, or the septum nasi is perforated and 

 blocked up with granulation tissue. The star-shaped cicatri.x: 

 is rare at least in an evident case of saccharomycosis. 



Clinicallj' in slighter cases of nasal affection there is no dis- 

 charge from the nostrils ; in anotlier case we find discharge of 

 thin fluid or mucous or muco-purulent or bloody or ichorous 

 fluid, and the breath is often stinking. When stenosis takes 

 place, respiration becomes difficult and snuffling. 



SaccJiaroiiiycosis of lymph, glands s. Lymphadenitis saccharo- 

 mycotica. It is interesting to note that the intermaxillary gland 

 is less affected, and is not in all cases a complication w3f nasal 

 changes. In an advanced nasal affection both intermaxillary 

 glands are swollen ; but in slighter cases this is not always so. 

 The same swelling is observed wlieii the face is affected. 



Clinically the swelling is moderately hard and freely 

 movable ; not knotty nor so hard as in true glanders ; it is also 

 not so e.xtensive as in str.mgles. Anatomically the swelling 

 consists either of simple hyi)erpLisia or of medullary swelling or 

 medullary herds or nodules are embedded in the hyperplastic 

 cortex. .Sometimes small abscesses are found ; in the pus and 

 medullar}' herds a certain number of saccharoinyces is always 

 present, while in the hyperplastic portion the latter are very 

 seldom or never found. 



IMore common is the affection of lym[)h. glands of the axil- 

 lary, inguinal, and plical regions, as the extremities are com- 

 monly affected. In all cases the induration of the gland, in the 

 strict sense of word, has never been stated, at least in the 

 observed cas£S. The anatomical character is quite the same as 

 in the skin. 



