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July 13, 1901


JAMA. 1901;XXXVII(2):117. doi:10.1001/jama.1901.02470280041013

The etiology of noma has been made the subject of frequent inquiry in recent years, but the results have been otherwise than uniform. This is probably unavoidable on account of the large numbers of various kinds of organisms necessarily freely present in areas so exposed as those usually attacked by noma. It is true, however, that in several instances of noma competent investigators have demonstrated the presence of diphtheria bacilli. Beginning with Bishop and Ryan, in 1895. who described a pseudodiphtheria bacillus, or a true diphtheria bacillus of greatly reduced virulence, Freymuth and Petruschky, in 1898, found diphtheria bacilli associated with two cases of noma, one of the genitalia and one of the alveolar process. Both of these cases were cured by the use of diphtheria antitoxin. And now comes Walsh1 with a report of eight cases of noma, in all of which he found B. diphtheriæ, as determined