Fig. 125.—Cases of Gangosa from Guam. (U. S. Naval Medical Bulletin.)
Kerr, who has been an advocate of the yaws etiology, has shown that of 315 cases of gangosa, 205 could show yaws scars and knew where the mother yaw had been and of the entire 315 only 18 claimed never to have had yaws and failed to show scars.
Rossiter, who observed active ulcerations of the nasal septum and hard palate in the case of a two-year old Samoan child, following yaws, states that he found yaws treponemata in smears from the ulcerated areas.
Epidemiology.—If gangosa is a sequel of yaws then the same factors which are operative for yaws apply to gangosa.
Pathology
Sections made from the ulcerating margins of the nasopharyngeal lesions have failed to show treponemata when stained by Levaditi’s method. In sections of such tissue stained by Giemsa’s method I noted a rather marked infiltration with lymphocytes and a great number of mast cells. Fordyce has noted the presence of giant cells.
From the histological study one can only state that the lesions present the characteristics of the granulomata.
A remarkable feature of the disease is the rapidity with which ulceration destroys cartilage and bone. The nasal duct seems to be prone to attack and it is through this channel that the process reaches the eye to bring about its destructive tendency in that organ.