manipulating fingers, there are sore spots that the patient describes as bruised. They may be extremely tender, though the patient is not aware of them until you find them with the battery sponge or the finger. These sore spots may be found anywhere over the chest or abdomen, but are particularly common at the attachment of tendon to bones, the joints between the ribs and the costal cartilages and the joints of the sternum, especially the joint between the ensiform and the gladiolus. My idea was that if there were any stiff or tight muscles restraining the action of the ribs, the faradic exercise would limber them up.

I treated this patient twice a week for three months and had the satisfaction of seeing this asthmatic sensitiveness entirely cured; for he has remained free from it ever since, now twenty years. This case lead me to try the current on hay fever patients, passing the current over the eyes and nose and sometimes inside of the throat, wherever there was itching, just as Dr. Metcalfe had done with his manipulating finger. If cough or asthma were present, I treated them as in the case of the artist just described.

Treatment. With one sponge on the nape of the neck or between the scapulæ, pass the other sponge over the eyes, nose, and throat for ten minutes. Use a gentle current, just enough for the patient to feel it but not strong enough to cause pain. If cough or asthma are present, twitch the respiratory muscles for ten minutes more, not forgetting that the respiratory muscles include the abdominal muscles, those of the whole length of the spine, and the cervical muscles all around, as well as the pectorals and the scapular muscles.

In regard to polarity, I do not think it makes any real difference which pole is used in each place. I am old-fashioned enough to remember when the polarity of a faradic battery was determined by holding two sponges of equal size, one in each hand, turning the current on quite strong and calling the stronger one the negative. In those days I learned to use this "negative" pole for active treatments and this is still my habit, putting the positive on the back and twitching the muscles with the negative. If this exposition seems crude to the modern electro-therapeutist, I can only say that I am not writing a treatise on electro-physics, but relating the experiences in actual practice over a period of nearly thirty years. The customs in which I was brought up are good enough for me until I see real reason for changing them. The electro-therapeutist is at liberty to turn the sponges around and use them the other way if it appeals to him as more fitting.

One of the most brilliant cures of hay fever with faradic electricity was made by Dr. Thomas P. Birdsall, of Pawling, New York, about fifteen years ago. The patient was a farmer's daughter of twenty years who had lived all her life on a farm in Putnam County and had suffered many years from hay fever. Dr. Birdsall used the faradic current from a small portable battery three times a week, while the patient remained on the farm in the irritating environment, and in one season made a cure that has lasted to this day.

Other Forms of Electricity. It is probable that all forms of electricity will relieve or cure hay fever. I have used the faradic current because it was the most convenient. It is still the most convenient current for most physicians. The old reports are of the galvanic. Ballenger recommends the leucodescent light. I have seen several reports of the use of the high frequency current and Tousey devotes a short paragraph to it, as follows:

"The author suggests the use of a glass vacuum electrode insulated by a double wall except at its extremity, which can be applied to all parts of the nasal mucosa but especially to the inferior and middle turbinated bones.... A similar application may be made to the outer surface of the nose at the sides, halfway from the root to the tip." (Second Edition, page 598.)

From my experience with patients I doubt whether many of them would submit to the intra-nasal spark. A theoretical objection to using any form of high frequency or diathermia on the outside of the nose is that, in some skins, frequent application of these currents causes a permanent dilatation of the capillaries of the skin, resulting in permanent redness. I tremble to think of the wrath of the fair lady whom you should cure of the hay fever by endowing her with a permanently red nose. I know that these currents are used on the face freely by dermatologists and have often made a few applications to break up a catarrhal cold; but I have seen cases enough of capillary dilatation and its intractability to make me pause and choose for the nose and face the surely safe faradic current rather than the more spectacular but risky high-frequency.

CHAPTER VI

HAY FEVER AS URTICARIA

The fundamental error in all the literature on hay fever is the teaching that the lesion is a peculiar kind of catarrhal inflammation; whereas it is not an inflammation at all, catarrhal or any other kind. The symptoms of hay fever resemble those of catarrhal inflammation, but the resemblance is only superficial. The resemblance is striking and must be so to have deceived so many skilled observers, but it is only superficial, nevertheless.

When you see a patient with eyes red and swollen, overflowing with tears and mucus, burning and sensitive to light, you say at once, catarrhal conjunctivitis. In the nose the sneezing, the discharge, the obstructive swelling suggest at once catarrhal rhinitis. But stop a moment. Did you ever cure a catarrhal conjunctivitis or rhinitis in three minutes by moving the patient from one room to another? You can do that with hay fever. If you can remove the patient from the irritating atmosphere, the swelling and redness will subside rapidly, the discharge cease, and in five or ten minutes you would scarcely know by examining the patient that there was anything the matter with his eyes and nose. By returning him to the irritating atmosphere the symptoms will return instantly. By removing him again, they will rapidly subside. I have watched this many times in my own eyes. It was in watching the changes in my own eyes and nose that I realized that this was no catarrhal inflammation but a much more superficial lesion.

Did you ever see a catarrhal conjunctivitis that acted in this way or a cold in the head in which the patient could be cured and catch a fresh cold twenty times a day? I think you never did. A true inflammation requires time, a few hours, for its development, and when an inflammatory exudate oozes into the meshes of the tissue, it requires some days or at least some hours to be absorbed. This one point of rapid appearance and rapid disappearance would forbid our calling the lesion of hay fever a catarrhal inflammation.

Next, associate this rapid appearance and disappearance with the chief symptom of hay fever, the itching, the intolerable itching, of the eyes, nose, and throat, itching that ceases at once on removal from the irritating atmosphere and returns instantly when the irritating atmosphere is reapplied. Turn to the skin, the external mucous membrane. What is that disorder of the skin that appears abruptly, presents redness, swelling, and intense itching, and ceases abruptly after a few minutes or a few hours according to your ability to get rid of the irritating cause,—that can be reproduced any number of times by exposure to the same cause? Why, hives, of course,