[Reprinted from The Medical News, March i 6, 1895.] 
ASTHMA AND ANEMIA RELIEVED BY RE- 
MOVAL OF NASAL POLYPI. 
By J. B. SCOTT, M.D., 
OF GETTYSBURG, PA. 
Although it is well known that nasal affections cause 
asthma, it would appear from the history of this case 
that the fact is not generally given the recognition that 
its importance demands. I therefore report the case just 
as it happened, because it seems to constitute a strong 
plea for the more general examination of the nasal pas- 
sages in diseases of the respiratory tract, and also of the 
circulation. 
Five years ago, an elderly lady came to me for treat- 
ment for bronchitis, asthma, and a condition of general 
malnutrition. She was anemic; the pulse was irregular 
both in frequency and in power; there was no cardiac 
murmur. The nasal passages were not examined. The 
bronchitis and the general condition improved under 
treatment, but the asthma was uninfluenced. At the 
close of the summer she changed her residence, and 
during the five years past has resided in several of the 
cities of the Middle and Southern States. In each place 
she was treated by physicians of reputation, some of 
whom were eminent. The result was invariably the 
same, some improvement in the bronchitis and general 
health, but the asthma grew worse. None of the phy- 
sicians examined the nose. Last summer she again came 
to me, and greeted me with the remark: “ Doctor, I 
don’t expect you to relieve the asthma; it seems no one 
can do that in all these years, but if you can only give 2 
me something to relieve the awful dryness in my mouth 
at night, so that I can get a little sleep, I will be grateful.’’ 
As there was no local disease of the mouth to account 
for the dryness, mouth-breathing due to nasal obstruc- 
tion occurred to me as a possible explanation of the 
symptom, and an examination was made through the 
nasal speculum. The left nostril was seen to be literally 
packed full of mucous polypi, while in the right passage 
a big one, looking like an oyster, acted like a ball valve, 
alternately opening and closing the slight air-current 
that found room to pass. Here seemed to be the solu- 
tion of the whole problem. Nasal respiration being im- 
possible, the mouth necessarily remained open and 
became dry, while the inspired air, deprived of the 
warmth and moisture normally imparted by the nasal 
mucosa, irritated the bronchial tubes, and maintained 
the chronic inflammation. The feeble and irregular 
circulation was due to a reflex action on the heart. 
The patient having been told that some benefit might 
result from removal of the polypi, readily assented to 
the operation. The polypi were attacked with a Bos- 
worth’s snare and Allen’s forceps. I say “attacked,” 
because it proved to be a right bloody battle before they 
were gotten out, but it ended in victory, for that night 
the patient was entirely free from asthma—a new experi- 
ence to her. The next night, however, there was a slight 
return. Examination showed that a small polypus, 
which had pressed out from one of the recesses of the 
cavities, after the removal of the others, was obstructing 
the passages. It was removed, and with it disappeared 
the last vestige of the asthma. Three months have 
passed without any attack, while before they were of 
nightly occurrence. 
Although a sharp exacerbation of the bronchitis re- 
sulted from exposure to cold, it was unattended with any 
asthmatic symptoms. It, therefore, seems clear that the 
asthma was due to the polypi, because it stopped on the 3 
removal of those obstructing the passage; it recurred 
when one hidden from view at first appeared in the left 
cavity, and because the exacerbation of the bronchitis 
was not attended by any asthmatic paroxysm. The whole 
physical condition of the patient was improved, probably 
as a result of the more perfect respiration, and conse- 
quently more perfect oxygenation of the blood. The 
varied experience of this patient seems to show that, 
even in certain high places, examination of the nasal 
passages is not a routine measure, and it certainly shows 
that it ought to be in diseases both of the respiratory 
tract and also of the circulatory system, particularly in 
anemic cases.