Digital examination and treatment of certain morbid conditions of the nasal chamber ; Age and sex in diseases of the upper respiratory tract / by Harrison Allen.

  • Allen, Harrison, 1841-1897.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Digital examination and treatment of certain morbid conditions of the nasal chamber ; Age and sex in diseases of the upper respiratory tract / by Harrison Allen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    have general impairment of nutrition. I have never seen this phase of disease earlier than middle life. Among these patients one was forty years of age ; a second, thirty-five ; a third, fifty-six ; a fourth, fifty-two.' In all of these cases the conditions had existed for many years. A gouty disposition was inherited in two. Delicate diges- tion was present, and in one, inherited dyspepsia. In two, a neurotic element was ver^’- highly developed and exhibited peculiarities which I think have warranted separate descriptions. (Cases VI and VII.) When the gouty element is predominant, the cause of the nasal complications being detected, the cure results when this exciting cause is removed ; but if, as a result of a rheumatic or gouty inherit- ance, this escapes detection, or when found, cannot from its nature be removed, the hay fever state will then continue in spite of all local treatment. Permit me at this place to make a few remarks on the general subject of hay fever. In two cases of children, one six years of age the other not ascertained, the symptoms of hay fever entirely dis- appeared after the removal of the ordinary pharyngeal adenoid growth. No treatment in either of these patients had been directed to the nasal chambers, and it appeared to be a reasonable conclusion that the morbid condition was dependent upon the adenoid mass. It is noteworthy that the most unfavorable subjects—that is to say, those in whom the least has been accomplished by treatment— are vigorous young adults. I have had an opportunity to studj’^ such a case in the person of a farmer whose surroundings were of the best; the general health was good ; the initial attack was abruptly announced after a coryza. The most careful examination did not show a condition, either of the pharynx or nasal chambers, which suggested a cause for hay fever, nor was treatment followed by any degree of success worth mentioning. A second case, a merchant of Washington, D. C., exhibited almost identical conditions. A long treatment produced an ameliora- tion after the first season, but the disease returned in subsequent years. In another case, a young lady who was relieved of the irritative states between the typical attacks, did not escape the exacerbation incident to the heat of summer. To this group, as represented in the last three cases, the description of older writers accurately applies. Hay fever appears to be a complex condition which results from many exciting causes. It is already seen that the condition may be a reflex from different irritations. The following case is an example of its nature, being evidently due to impaired nasal respiration or to mechanical states as the result of pressure. A professional gentleman who had suffered for a number of years with a disposition to headaches, during the heated term, also suffered from the symptoms of coryza and lachrymation, at other times of the year, found himself getting gradually worse, and reported to see whether something could not be suggested for his relief. I found the left nasal chamber the narrower of the two and the vomerine spur projecting into the left lower turbinal. I suggested * This Statement is made advisedly, for general writers assure us that hay fever is apt to lessen ia <cvcnry after mid He age.