It has been known for a long time that noma occurs in persons, especially children, when the general resistance of the body tissues has been lowered by various diseases, more especially by measles, but also by pertussis, scarlatina, typhoid and typhus fevers, and in one case, reported by Le Count, by amebic dysentery. Writers have generally suspected that some "specific agent" acts upon such susceptible tissues to produce the gangrene, and various investigators have described bacteria which they believed to be the essential cause of the necrosis, but subsequent research has failed to demonstrate the constant presence of any one of these microorganisms.
In October, 1895, Bishop and Ryan1 reported before the Chicago Pathological Society a case of noma and two cases of ulcerative stomatitis, all occurring in brothers who had recently recovered from measles. From the case of noma and from one of the cases of ulcerative stomatitis,
DIPHTHERIA BACILLI AND NOMA.. JAMA. 1902;XXXVIII(5):326–327. doi:10.1001/jama.1902.02480050040004
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