I do not know that I will be able to say anything new of this morbid condition of nose, but will state a few things as I see them in practice day by day. There is always a favorable point about having a patient with this disease, along with the unfavorable ones. That is—the physician always has plenty of time to study his case and see every minute change in the recovery ere the patient is pronounced cured. This is more commonly known as ozena, or fetid catarrh, from the odor which accompanies the trouble. However, there is a form of the disease in which the atrophy is present, but has no fetor accompanying it. The latter is a much drier form with no secretions at all. The ætiology of this disease has been discussed pretty thoroughly. It has been a question as to just what the initial symptoms and changes really are. In a majority of cases it is a secondary disease. That is, it follows other forms of rhinitis. Some authors claim that atrophic rhinitis follows the hypertrophic rhinitis. Others claim that there may be some shrinking in hypertrophic rhinitis, but that it does not end in atrophy, but comes from the purulent rhinitis: I believe they both are right. Either form I feel confident may precede atrophy. Again, I do not think that hypertrophic or purulent rhinitis is always followed by the atrophic form. If they were we would have many more cases of atrophic rhinitis to treat than we do at present. In my opinion this disease is brought on directly at times from various causes. Many a case of ozena has been brought on by the indiscriminate use of caustics on the mucous membrane of nose. Also injudicious cutting away of inferior and middle turbinated bones. Then again there is a predisposition to disease, especially in those people with a syphilitic and scrofulous diathesis. Excessive drinking of alcohol, excessive smoking of tobacco, working in poorly ventilated rooms or where there is a great deal of dust, and where there is an impoverished condition of blood from malaria or malnutrition, all have a tendency to set up this disease. The name of this ailment tells much of the pathology of the disease. As atrophy implies, there is a wasting away of all tissues attacked. Upon examination the first thing observed is a dry, shriveled state of the mucous membrane of the nose and pharynx. The glands and follicles are all obliterated, which accounts for the dryness of the mucous membrane. The turbinated bones are dwindling away. Frequently the whole anterior portion of the turbinated bones is absorbed. This causes the nasal cavities to be so enlarged that we may see the pharyngeal walls from the anterior opening of nose. The glazed or dry appearance extends to the pharynx and in this manner affects the eustachian tubes. All over the nasal cavities and pharynx numerous granulations can be noticed. Tortuous and enlarged vessels run over the walls. As a rule there is not that bright red congested appearance of membrane as in other forms of catarrh.