CHAPTER VIII.
RHINOSCLEROMA.

IN Austria, Hungary, Italy, and some parts of Ger-
many there sometimes occurs a peculiar disease of the
anterior nares, characterized by the occurrence of circum-
scribed tumors, known as rhinoscleroma. The tumor-
masses are somewhat flattened, isolated or coalescent,
grow with great slowness, and recur if excised. The dis-
ease commences in the mucous membrane and the adjoin-
ing skin, and spreads to the skin in the neighborhood by
a slow invasion, involving the upper lip, jaw, hard palate,
and sometimes the pharynx. The growths are without
evidences of inflammation, do not ulcerate, and consist
microscopically of infiltration of the papilla and corium
of the skin, with round cells which change in part to
fibrillar tissue. The tumors possess a well-developed
lymph-vascular system. Sometimes the cells undergo
hyaline degeneration.

In these little tumors the researches of Von Frisch dis-
covered little bacilli much resembling both in morphol-
ogy and vegetation the pneumo-bacilli of Friedlander,
and, like them, surrounded by capsules. The only
marked difference between the so-called bacillus of rhi-
noscleroma and the Bacillus pneumonise of Friedlander
is that the former stains well by Gram's method, while
the latter does not, and that the former is rather more
distinctly rod-shaped than the latter, and more often
shows its capsule in culture-media.

The bacillus can easily be cultivated, and in all media
resembles the bacillus of Friedlander too closely to be
distinguished from it. Even when inoculated into animals
the bacillus behaves much like Friedlander's bacillus.

Inoculation has, so far, failed to produce the disease
either in men or in the lower animals.

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