[Reprint from The Laryngoscope, St. Louis, October, 1896.] 
HAY FEVER; THE BEST TREATMENT FOR STAY=AT= HOMES. 
BY WILLIAM CHEATHAM, M. D. 
Professor of Ophthalmology, Otology ajid Laryngology In the Louisville Medical College, 
etc., etc., Louisville, Kentucky. 
“ Hay Fever,” as a name for the affection with which it is associated, 
is, we all recognize, a very defective one. I use it because I know of 
no better. 
In the few remarks I propose to make upon this affection, I suppose 
all local causes of nasal stenosis and irritation to have been removed. 
The cases I report will be mostly those that have been under my 
observation for one or more seasons, unable for different reasons to 
visit the usual resorts of “hay fever” sufferers, and who have had all 
forms of treatment with no permanent relief. 
Mrs. H., married, housekeeper, age twenty-four years, no children, 
has had “hay fever” for six years. This is the third year I have 
treated her. The trouble began this year as usual, August 15th. I 
saw her August 17th. The nasal symptoms were well advanced, and 
the eye symptoms just beginning. As in the two previous years, in 
which she has been under my observation, I gave her syrup hypophos- 
phites early in the summer. I gave her August 17th a small capsule 
of valerianic ether to prevent any ill effects from the cocaine solution 
with which I sprayed her nose. The cocaine, of course, shrinks all 
engorged tissue, and produces local anesthesia. I then twisted on a 
slender nasal applicator some absorbent cotton, and dipped it into a 
50% solution of chromic acid; this I applied the full length of both 
inferior turbinal bones, the lower half of the middle turbinals, and the 
lower two-thirds of each side of the septum. In two or three minutes 
I washed the nostrils well with an alkaline solution, and sprayed them 
with 1i mixture of eucalyptol, camphor, cocaine (alkaloid), and vase- 
line. I gave her a wash to use so long as the secretion was excessive, 
containing aqua eucalyptol, aqua camphor, and distilled extract hama- 
melis, equal parts; under this treatment the symptoms were much 
wdrse that day, but better the next. This treatment occasionally has 
to be repeated once, very occasionally twice, during the season. I 
afterwards gave Mrs. H. valerianate zinc and extract nux vomica. 2 
This treatment usually prevents the asthma and cough. Should the 
latter cause much trouble, I find nothing proves so harmless and so 
effective as codeine phosphate. So far this year she is quite com- 
fortable. 
Mr. Gr., railroad manager, had his first attack September, 1894. 
This year it began August 10th. I saw him first August 14th, 1896. 
His general health seems to be good. I found him suffering very much, 
unable to attend to his business, could not sleep at all, nose com- 
pletely occluded, no asthma or cough, but his eyes disturb him very 
much. After cocainizing his nose thoroughly, I found no hypertro- 
phied tissue, but the nose very narrow and the turbinal bones very 
small. I made an application of a 25% solution of chromic acid and 
washed it out well in a few minutes with an alkali; then used the vase- 
line mixture in a spray. I gave him the same wash Mrs. H. is using, 
giving him also zinc phosphide and extract nux vomica internally. 
He reported next da}T much improved; had slept well. This improve- 
ment continued until Friday, August 21st, when he reported with an 
exacerbation; another application of the acid was made, since when he 
has been quite comfortable, attending his business without trouble. 
His eye symptoms persisted a few days, when I gave him acid boric, 
aqua camphor and aqua rosa, cia 5bi> distilled extract hammamelis q. s. 
gviii, as an eye bath; he used it in a glass eye bath four times a day 
and soon got relief. He complained of little or no discomfort from 
the acid. 
Mr. Gr., a contractor, has had the above treatment for four years, 
with entire relief. Before I began treating him he had to leave the 
State every summer. I removed some hypertrophies from both nos- 
trils and a ridge of bone the first year I treated him. Mr. Gl. works 
in a great deal of dust. He commences early in the spring, as he has 
mild “rose fever,” on the zinc phosphide and extract nux vomica, and 
the wash of eucalyptol, hamamelis and aqua camphor. The acid ap- 
plication gives him one day of discomfort, after which he returns to 
his work in dust and dirt with no discomfort. He uses the eye bath 
also. 
Mrs. H., married, weighs 253 pounds; has a baby about once a 
year; has asthma about one-half of the year; has violent exacerbations 
which can be relieved by weak chromic acid applications to the nose, 
and phosphate of codeine internally. During “hay fever” season 
Mrs. H. has one and sometimes two applications of the chromic acid, 
which give her great comfort. She uses the wash previously mentioned 
and valerianate of zinc; this latter I have been using in these cases for 
some years, with great benefit, I think; I sometimes give the three 
valerianates. 3 
So far this season I have had but one patient, a Sister of Mercy, 
who has not gotten relief from the treatment given above. She came 
in late in the season, with asthma and a bad cough. I had never 
treated her before. Her nose is exceedingly contracted; healthy tur- 
binals nearly produce total stenosis With the slightest engorgement 
she cannot breathe through her nose at all. Cocaine will not reduce 
this engorgement now. I refer to the case as one impossible to relieve 
without the aid of surgery. 
Only Sunday last—September 6, 1896—Mr. 0., a merchant, who 
has just returned from a trip to Alaska, came to see me with an attack 
of “ hay fever.” This is the third year I have treated him. I made 
the chromic acid application, and have seen him twice since; he is 
much improved. It has always relieved him before. 
September 1, 1896, Mr. S., of Augusta, Ga., called to see me, 
suffering intensely with “hay fever.” I never saw a man more un- 
comfortable. No asthma, but head symptoms well marked. He has 
had “hay fever” for fifteen years. I gave him the usual treatment, 
and that same day he was called to New York on business. For four 
days and nights he was so uncomfortable he could neither eat nor 
sleep. He stopped all treatment, both local and internal. From a 
description of his symptoms he afterwards wrote me, he must have 
had mild sepsis. After the fourth day he began to eat. An extract 
from his letter, given below, shows the progress of his case from that 
date. His right nostril is nearly completely occluded by a deviated 
septum. I advised a correction of this. 
Mr. S. writes September 9th as follows: 
“ I have not sneezed as many as half a dozen times in any one day. 
I have no itching sensation in the eyes, ears or nostrils, and I sleep 
at night without discomfort, and as a healthy man should do. I 
breathe freely through both nostrils; the discharge of clotted blood 
and mucus has greatly diminished, and the bleeding of the right nos- 
tril has almost entirely ceased. Ordinarily, this is the time that the 
fever is reaching its climax. I do not know whether it is coming back 
or not. It almost passes belief that I am free of it at this time.” 
For the asthma I have found ten or fifteen grains of bromide or sal- 
icylate of quinine at bedtime gives great relief. Also glyceride of hy- 
driotic acid is very good. When there is a gouty element urotropine 
is of service. Mixtures containing lobelia, the bromides and the 
iodides are of much service; of course when the asthma is very severe, 
morphia and atropia act very promptly. 
To summarise then, for “hay fever” sufferers who have to stay at 
home, I believe greatly in constitutional treatment, such as the Valeria- 4 
nates, the hypopliosphites, zinc phosphite, anti-rheumatics, and in the 
correction of any gouty element. 
Locally, the removal of all causes of nasal stenosis and irritation, 
with persistent cleansing with mild saline, acid and alkaline solutions. 
Just before, at the beginning, or in the midst of the season, I apply, 
as given above, chromic acid, and follow this with such medication as 
indicated in the body of this paper. But few of my patients have any 
discomfort, except for a few hours, from the treatment, which occa- 
sionally has to be repeated, and they are thus enabled to stay at home 
and attend to business with very little or no comfort. The chromic 
acid, as in Mr. S. ’s case, sometimes gives great discomfort. Much of 
his discomfort, though, came from his neglect of treatment. Even 
with this four or five days of discomfort the result of the treatment 
more than counterbalances the many uncomfortable days of the “hay 
fever ” sufferer, if a stay-at-home.