began in April and lasted until October. By one of those ironical tricks that fate plays on the great ones of the earth, rosin-weed, the family remedy that cured everybody else, gave me only partial relief. It is unnecessary to follow in detail the various experiments made. This was long before the days of Dunbar's pollantin, Holbrook Curtis' ambrosia, adrenalin, and the modern vaccines. I did not think cocaine a safe drug and never used it, preferring the hay fever to the cocaine habit. About this time ichthyol was introduced by Merck for the treatment of catarrh of all mucous membranes and I found that ichthyol, used in a certain manner, relieved the symptoms completely. On swabbing the naso-pharynx with pure ichthyol, there was a severe burning sensation for a minute or so, but, when the burning subsided, there was great relief, not only of the itching throat but also of the itching of the eyes and nose. That is, in the customary swabbing of the naso-pharynx, we touch a point that controls the whole group of symptoms of the eyes, nose, and throat.

In those days the laryngeal and pharyngeal tonsils were very much to the fore in medical discussions, and at first I thought that this point was probably the pharyngeal tonsil of Luschka. However, judging from the location of the most severe burning, the controlling point is rather on the upper surface of the soft palate. The exact location of this point is not of practical importance. If you swab each side of the naso-pharynx with plenty of ichthyol, the reflex contraction of the pharynx while the swab is in it will spread the ichthyol over the right territory.

CHAPTER IV

MENTHOL AND EUCALYPTOL

The ichthyol treatment described in the last Chapter is very effective, but it burns severely for a few minutes and, for this reason, some patients will not endure it. With children, it is impossible. Another disadvantage to the patient and, sometimes, to the doctor, too, is that it requires the patient to come to the doctor every day for the application, though Dr. Hollister tells me that he had one patient who learned to apply the ichthyol to her own naso-pharynx and, what is more wonderful still, kept up the treatment long enough to get well. In recent years I have hit on a treatment that is more comfortable than ichthyol and in many cases equally effective, though a little slower in giving relief. It can be carried out by the patient with little trouble and requires no skill in handling nasal swabs, an important matter with nervous patients and children.

I have found that the ordinary solution of menthol and eucalyptol and thymol in liquid albolene will relieve hay fever if applied to a certain spot a certain number of times a day. At this point I can see the reader's face assuming an expression of pained surprise. What is there wonderful about that? Is there not a bottle of this solution on the table of every doctor in the country and does not every modern textbook on the Nose and Throat advise inhaling vapor of such a solution to relieve hay fever? True. Note that I did not say that simply spraying this solution in the nose and throat will cure hay fever. I said that it must be applied to a certain spot a certain number of times a day. It is a case of the technique being more important than the remedy; for I have no doubt that there are other medicines than ichthyol and menthol that will relieve if put on the right spot. The reason that every doctor has not discovered for himself the full value of this commonly used solution is that he did not put it on the right spot and he did not use it often enough.

The Right Spot, as related in the chapter on Ichthyol, is either the vault of the pharynx or the upper surface of the soft palate.

Frequency. Once or twice a day is insignificant. It must be used every hour or oftener when the symptoms are acute. Here I borrow an idea from the dermatologist who learned long ago from Unna that when an ointment rubbed on twice a day fails to cure an eczema, it may be cured by keeping the same ointment constantly applied to the part, day and night. The naso-pharynx of the hay fever patient requires the same continual application of the cure and we come as near as possible to a continual application by applying the solution every hour or two.

Such frequent applications are impracticable as office treatments, but must be carried on at home or at business by the patient or a member of the family. If an expert hand is available to spray the naso-pharynx, the tip of the atomizer should be pointed forward so that the spray is directed into the posterior nares and the posterior surface of the soft palate as well as the vault of the pharynx. An adroit patient may learn to do this, but even an adroit patient, unfamiliar with the anatomy of the throat, may spray only the front of the palate and fail to get the solution correctly applied. To avoid these mistakes and insure the oil getting on the right spot, the patient should be taught the following simple technique.

Method of Application. Taking an ordinary atomizer full of the oil, the patient lies on the back with the head low or on one flat pillow. He must be able to breathe freely through the nostril to be treated. Usually, one side of the nose is free and he begins with that side, inhaling the oily spray freely. He then remains lying on the back with the head low while the oil runs backward into the naso-pharynx, especially on the upper surface of the soft palate, where it burns a little but not nearly as much as ichthyol. After two minutes or so, the other side must be treated, but it must first be opened up so that the patient can breathe freely through it. This is done by turning on one side so that the stuffy side is upper-most. In a few minutes this side will open up and the spray can be inhaled through it freely back into the throat. To be thorough, the patient treats each side several times. For the first few days the treatment should be carried out every hour or so. After a few days or a week mild cases get perfect relief and even severe cases may drop to four treatments daily. Such a method is far safer than cocaine, which should never be put in the hands of the patient for any purpose whatever.

For obstinate cases ichthyol remains the most effective of the local applications. With those adults who can learn to spray the naso-pharynx and who are heroic enough to bear the sharp burning for a few minutes for the sake of ultimate relief, I mix one-tenth ichthyol with the albolene spray solution. Ichthyol leaves the throat raw and uncomfortable for a few minutes. For this reason it should not be used as frequently as the albolene solution.

Ichthyol does not mix well with the albolene, but precipitates quickly. As it does not mix readily by shaking, the mixture must be stirred before using. The manufacturers, McKesson and Robbins, were good enough to experiment in their laboratory with mixtures of ichthyol and albolene. They report that they were unable to make a satisfactory combination and that "the only way to get a permanent mixture of the two would be by a process of emulsion, which would be too thick for spraying purposes."

It may be objected that my newly discovered point in the naso-pharynx is merely the posterior end of the inferior turbinated bone, as described by Mackenzie and Sajous and others long ago, and that the spraying of the nasal passages simply benumbs the sensitive areas, anterior, middle, and posterior, that are well known to rhinologists. This may be so. At any rate, the method just described makes