Ozena as derived from the Greek signifies properly a stench and had its place in early medical nomenclature. Primarily ozena was a t e r m given to a pathological process of the nose associated with the exhalation of a disagree able odor. The early Greek and Roman writers, Pliny and Celsus, limited its meaning to fetid ulceration of the nose. Pollus Argina regarded it as a rottening and purulent ulceration, caused by saturation of the interior of the nose by a sharp humor. This condition was

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... ntained until the twelfth century when Actuarius first proved an ulcerative process was not necessarily present and that ozena was caused by a decomposition of the se cretions. This theory of Actuarius was further developed at the beginning of the seventeenth century by Joannes Crato, who regarded this condition as an infectious disease. At the end of the seventeenth century, Vienssens, Reminger and Gunz, maintained that it was not an independent disease but depended upon suppur ation from the nasal sinuses. The above history was taken from Sendziak' s 1 description of atrophic rhinitis. THEORIES OF ETIOLOGY AND PATHOLOGY. Hereditary. Treitel has recorded cases of ozena in small children, the mother of two of them also suffering from it. Adams reported ten cases belonging to three families, the older members had atrophic rhinitis, while the younger had hyperplastic purulent rhinitis. Parker26 suggests that cases occurring in the same family may be due to inherited roominess of the nasal cavities. Lock6 says that hereditary predisposition is often very marked. He reports one family in which the father, mother, three girls and one boy were affected. Another family four sisters, one brother and the mother were affected, in this case the affected persons all had broad flat noses, while four other brothers and the father had narrow prominent noses and escaped the ozena. Grunwald2 7 states that the only evidence of hereditary predisposition consists in the fact that frequently several members of the same family present the symptoms of ozena. The advocates of this theory forget to mention the fact that this is quite exceptional. Contagion. Perez reports ninety-eight cases in which infection took place from one member of the family to another, thirtysix cases from some one outside of the family. Lermoyex believes it to be an infectious condition stating that the organism causes a purulent rhinitis which develops into an a-trophic rhinitis. Mermod1 2 regards the fact that ozena may be unilateral 9 Lack says that the Bacillus mucosus capsulatus is found in almost pure culture in the deeper, fluid part of ozena crusts. J Many of the organisms separated may be met in other conditions. The bacteriology is not settled because of the difficulty of determining whether they are the direct exciting cause of the atrophy or only secondary and then the cause of the fetor. The Bacillus mucosus capsulatus or ozena is according to statistics the one most frequently found and the one supposed to act upon the stagnant mucopurulent secretions as putrefactive bacteria do. This bacillus along with others may be the cause of the ozenic odor, but there is no con clusive reason for believing that they have anything to do with the cause of the disease. The pseudo-diphtheria bacillus of Lautman according 16 to Hiss and Zinsser culturally show all the qualities of saprophytes. This tends to show that the odor of ozena is due to putrefaction. Cozzolini regards the microorganism as a secondary * event in the etiology. Some of the bacteria found are Lowenburg -Bacillus capsulatus. Abel ---Bacillus mucosus -identical to bacillus described by Lowenburg. Guarmania -Streptothrix alba. Lautman -Pseudodiphtheria bacillus. Perez ---Cocco-bacillus foetidus ozena. 6 50-Corapairad -Fetid Atrophic Rhinitis and its Oto-Cranio Cerebral Complications.