=De Mussy in France.= As might be expected, among French rhinologists and writers on general medicine, de Mussy's teaching is well known and has many advocates. Note that the writers mentioned by Stickerare all Frenchmen. The usual view is well expressed by André Castex in his _Maladies du Larynx, du Nez et des Oreilles_. Paris, 1907, page 425. "Hay fever attacks especially those who belong to an arthritic stock, whose parents have had or who themselves have migraine, gravel, eczema. This explains its frequency in England and America; for the Anglo-Saxon race is especially subject to arthritic disorders. In France it exists but is infrequent. In this way also we must explain why hay fever is rare among the laboring classes who frequent the hospitals and is observed almost exclusively among wealthy patients, people of sedentary habits and sluggish digestion (nutrition ralentie)." In Brouardel and Gilbert's _Traité de Médicine et de Thérapeutique_, Volume 27, page 66, another André, André Cartaz, expresses mild skepticism as to the proof offered. "The presence of an arthritic diathesis is accepted by many authors. Leflaive thinks it the sole predisposing cause, especially gout. During the attack he has demonstrated, as I would say, and that is proof for him, an appreciable decrease in the quantity of urine and percentage of urea, an increase in uric acid and, in one case, the presence of indican." Lermoyez also advises caution in accepting the gouty theory to the neglect of known remedies for the disease. I abstract his sensible remarks from his _Thérapeutique des Maladies des Fosses Nasales_, Paris, 1896. Article _Rhinites spasmodiques, rhume des foins_, page 300. "It would be a mistake to hold with the German school that the nasal lesions were the only cause of hay fever; for these lesions are completely absent in many true cases of the disease and, on the other hand, many people affected with hypertrophic rhinitis breathe air full of pollen without showing symptoms of hay fever. There is certainly a general predisposition. In hay fever certain patients present a peculiar idiosyncrasy, often inherited, almost always neuroarthritic. But to say with the French school that the arthritic diathesis (trivial diathesis, commonplace diathesis, _diathèse banale_) is the only cause of hay fever is to make a mistake that leads to inefficient treatment." =Conclusion.= How this discussion of the gouty nature of hay fever escaped English and American authors is a strange thing. British physicians frequent French hospitals and are familiar with French medical writings. In 1868 American physicians studied in Paris as they went later to Vienna and Berlin. It is strange that they never brought back with them this French theory of the gouty nature of hay fever and that no British or American author seems to have quoted from their books.