The consideration of syphilitic affections of the nose has always been of such interest that another paper on the same subject needs no apology, even though no new ideas can be advanced. Syphilitic conditions involving the nose at times take on very unusual forms, and very often do not in the slightest degree follow the classical picture described in the text-books. This is particularly true of late tertiary lesions. Tertiary manifestations, such as broken-down gummata, destructive ulcerative processes and caries followed by the well-known deformities, are, of course, very common, and are usually easily recognized. This is not so, however, when the tertiary lesion takes the form of a tumor—a syphiloma—particularly when no history of syphilis can be obtained. This form of the disease will be the only one considered in this paper.
A considerable number of cases of tertiary nasal syphilis have come under the writer's