FACIAL (EDEMA. 
03 
may be filled with tow or jute, in order to check the flow of blood into the 
larynx. 1 But the tampons must be secured by strong tape, that they may 
not fall into the pharynx and produce danger of suffocation. Under such 
circumstances it is advisable to perform tracheotomy and insert a tampon 
canula. One of Moller’s patients died from cerebritis, owing to the 
inflammation extending from the point of operation to the brain. 
The term “ rhinoscleroma ” was formerly given to a disease of the nose in 
man, usually following nasal catarrh, and producing general swelling both of 
the nasal mucous membrane and the external skin. The swelling, as the name 
indicates, is distinguished by its hardness, 
and may be of such dimensions that the 
nostrils are completely occluded. The 
Schneiderian membrane appears livid. 
Anatomically, the thickening is like that of 
elephantiasis, and, according to later in¬ 
vestigations, is caused by a specific infection 
—a micro-organism, similar to Fried- 
lander’s pneumococcus, has been found in 
the growth. Whether this condition occurs 
in the lower animals has yet to be deter¬ 
mined. The cases hitherto reported show 
peculiarities indicating other than micro- 
organismal causes. This view seems to be 
supported by a reported case of Jacobi’s, 
where recovery followed the injection of 
Lugol’s solution of iodine into the sub¬ 
cutaneous tissue. A similar case was given 
in the Zeitschrift fur Veterindrkunde. It 
cannot be denied that the nasal mucous 
membrane and the nostrils do become 
swollen as in elephantiasis, but whether 
such swellings should be looked upon as 
rhinoscleroma cannot be determined with- 33.—p ac i a ] oedema after injury, 
out a fuller knowledge of their nature. 
Thickening occurring about the nose in glanders might, however, be mistaken 
for rhinoscleroma. 
In an omnibus horse the upper and lower lips and the nose became extremely 
thickened. Both nostrils and the lower lip felt hard. The swelling was 
smooth on the surface and the skin covering it was denuded of hair and 
closely adherent. Some spots on the upper lip were deprived of pigment and 
appeared dull red in colour. The swelling was not sharply marginated abo\e, 
but gradually shaded off about 4 inches above the nostrils, extending somewhat 
higher, however, as it receded from the middle line of the face, and being con¬ 
tinued in the form of a slender cordiform enlargement up to the masseter 
muscles. 
The nostrils were 3-| inches in length. The anterior edge of the lips 
extended about 3 inches beyond the incisor teeth. The mucous membrane 
of the lips and nose was little changed, and there was neither nasal discharge 
nor difficulty in breathing. 
The submaxillary and prepectoral lymphatic glands were swollen and hard. 
1 Adrenalin chloride (1 in 1 , 000 ) applied to the mucous membrane before incision produces 
powerful contraction of the arterioles, and permits of practically bloodless operation. 
