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February 8, 1908


JAMA. 1908;L(6):455. doi:10.1001/jama.1908.02530320043004

In Dr. Senn's1 interesting letter from La Paz, Bolivia, he speaks of an "unknown disease" endemic in certain parts of the country, three cases of which he saw in one hospital. He describes the condition as "a granulomatous process which begins at the mucous or cutaneous margin of the lip—in preference the upper lip." The process spreads to the alæ of the nose and the septum, and finally spots appear on the hard and soft palates. Although Dr. Senn was probably correct in calling the condition an "unknown disease," it seems likely from the description that it is the tropical disease gangosa, to which attention has recently been directed by Leys, Mink and McLean, Stitt and other surgeons of the United States Army and Navy. The description given by Dr. Senn tallies well with their descriptions of gangosa. Fordyce2 described the disease and demonstrated it in a native

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