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.