I do not propose to treat this subject technically or theoretically,
further than to simply say, I consider the first a mild form of the
second, and both a reflex neurosis. I shall relate my experience and
treatment of some half dozen cases illustrating my subject.
CASE I.—Mrs. H., a farmer’s wife, æt. thirty-five, had been troubled
for a number of years with hay fever from harvest time until frost
came in the fall. Inspection of the nose in June, 1899, showed the
lower right and both middle turbinated bodies greatly hypertrophied.
Removal of the anterior and lower half of the middle and
cauterization of the lower, gave complete immunity for the entire
season. This patient could not, at any time, sweep the floor or ride
behind horses against the wind, without violent paroxysms of
sneezing, but since the operation has had no further trouble on this
score.
CASE II.—Mr. D., æt. about thirty-five, a traveling man, the patient
of our secretary, consulted me on August 28 last, in the midst of
his annual attack of hay fever. Examination showed the entire nasal
mucous membrane greatly engorged, as it always is during an attack.
On the right side of the septum, near the floor, was a sharp septal
spur, projecting at right angles about three-eighths of an inch,
prodding the tumefied lower turbinated body. The removal of this
spur under cocaine anæsthesia greatly modified the symptoms
immediately, but a grateful frost, following in a few days,
prevented an exact estimate of the benefit to be ascribed to the
removal of this offending appendage.
This year, however, will furnish opportunity to determine how
permanent the effect will be.
CASE III.—Wm. S., æt. four years, a great sufferer from asthma, at
times when having a slight cold, to which he was very prone, to such
an extent that he could not lie down for several days and nights.
Relief had been sought in the higher altitudes of the Rockies and a
residence of one year at Denver, but none came. I was consulted on
November 25, 1899. An examination showed the post-nasal space almost
occluded with adenoid vegetations. Of course I advised their
removal, which advice was accepted, and their thorough removal,
under the local application of cocaine, accomplished the purpose.
This was the child of a brother practitioner, and in April this year
I had a letter from the doctor, in which was the very gratifying
sentence, “William has not had the asthma since you removed his
adenoids, and is much better in every way.” This was especially
pleasing since his suffering had always been more severe and
constant during his previous winters.
CASE IV.—Male, æt. forty-five, Swede; occupation, bridge-builder.
Had suffered annually for fifteen years with, first, hay fever, and,
later in the season, asthma. In the summer of 1899 he anticipated
his attack by a trip to the mountains of Colorado, where he found
exemption and remained until the first frosts had appeared here, and
then ventured to return. Immediately on arriving at Omaha on his
return, his old antagonist met him and the battle again raged with
even renewed vigor. He consulted me a few days after his arrival
home, in a frame of mind ready to accept any suggestion which
promised him relief. I examined the nasal passages. The right lower
turbinated was greatly hypertrophied, and on the application of
cocaine, 3 per cent. solution, the tumefaction largely disappeared
and great immediate, but of course, temporary, relief was
experienced. On the left side an immense septal spur on the osseous
portion was found and removed. After the temporary swelling incident
to the operation had subsided, his relief was, and remains,
complete. I subsequently cauterized the enlarged right turbinated,
since which time, he informs me, he has breathed more freely than he
has done for fifteen years.
CASE V.—Lady, æt. about twenty-eight, married, had consulted all the
physicians in her home town, except the one she should have at first
consulted. Finally, in desperation she went to a young up-to-date
homeopathic physician, who looked into her nose and assured her he
knew what caused her trouble. He made an application of a solution
of cocaine, and in a few minutes her respiration became nasal and
normal. “Oh, what a relief! That is the first good breath I have had
for weeks,” was her exclamation. Both lower turbinated bodies were
immensely hypertrophied, and the doctor wisely advised their removal
and referred her to me to do the work. When I first saw the patient
she was a frail, pale, wan little woman, thoroughly exhausted. I saw
her about six weeks subsequently, in a remarkably improved
condition. Had gained about twenty pounds in weight and was plump,
rosy-cheeked, and had entirely lost her distressed appearance.
The last two cases both occurred in the practice of my good friend, Dr.
C. M. Harrington of Knoxville, Ia., and are all the more valuable
because he is here to corroborate the fair statement of the cases I have
made, and emphasize the beneficial results in a discussion of my paper.
CASE VI.—An old-school physician, æt. about thirty-five, had for a
number of years been troubled during the late summer months and
early fall with hay fever. Had sought relief from a number of
specialists in his own school of medicine as well as prominent
general practitioners. By chance he was directed to me, not knowing
my school of practice, in the midst of attack in 1899. No
satisfactory examination could be made until a 4 per cent. solution
of cocaine had been applied and caused a lessening of the
engorgement. There was plainly visible a large well-organized simple
polypus hanging by a distinct pedicle from the right middle
turbinated body. Its removal with the cold wire snare gave prompt
and permanent relief and made a lasting and loyal friend of my
old-school confrère.
In none of these cases do I mention any medication. None was used except
to cleanse the mucous membrane of the viscid secretion always present in
such conditions, and following such operations. All of the cases
reported were mechanical obstructions, and demanded mechanical
treatment, and no line of medicinal treatment would have done more than
temporary good.