Produced by Richard Tonsing and the Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive) VOL. XII. JULY, 1900. PART 3. THE JOURNAL OF OPHTHALMOLOGY, OTOLOGY AND LARYNGOLOGY. EDITOR, CHARLES DEADY, M. D. ASSOCIATE EDITOR, A. W. PALMER, M. D. NASAL OBSTRUCTION AS A CAUSE OF HAY FEVER OR ASTHMA. BY WM. WOODBURN, M. D., DES MOINES, IA. 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.