SOCIETY PROCEEDINGS 87

Interesting Observations in the Diagnosis and Treatment of the Atypi- c~~Tw of Hay Fever. H.B. WILMER, PHILADELPHIA.

The following conditions were observed and treatment instituted : 1. Cases having definite hay fever symptoms with no positive skin or

conjunctional reactions. Those whose symptoms conformed to the time of pollination of the common pollens, showed relief or improvement in about 60 per cent of the cases, when treated with these pollens.

2. Cases with asthma but no hay fever symptoms occurring in the hay fever season. Some of these gave positive skin reactions, and treatment of these with pollen extracts was excellent. Those who gave no positive skin reaction did not do so well.

3. Cases of hay fever that received no relief when treated presea- sonally by the “long interval” mebhod, were treated the next season as follows : A daily injection was given for two weeks before the onset of pollination and then once a week for the entire season. Results were good.

4. Cases giving positive skin reactions to pollens, with attacks of hay fever throughout the year. It was proved that, in these instances, pol- len was harbored in floor coverings, books, etc.

5. Cases of asthma and hay fever that failed to respond to pollen extracts alone. Supplementin g this treatment with autogenous bac- terin induced good results in about 60 per cent of the cases.

6. Cases of vernal conjunctivitis. Here, positive skin reactions were unusual, but conjunctival reactions when present were significant. These were induced particularly by tree pollens.

Other conditions occurring during the hay fever season were con- sidered, but the number of cases were too few to be significant. These included cases of ,bladder tenesmus, generalized dermatitis, and eczema.

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THE ASSOCIATION FOR THE STUDY OF ALLERGY

SEVENTH ANNUAL MEETING, PORTLAND, OREGON, JULY 8, 1929

Cooperative Studies in Ragweed Pollen Incidence. 0. C. DURHAM, INDIANAPOLIS, IND. (For original article, see page 12.)

Cedar Hay Fever. J. H. BLACK, DALLAS, TEXAS. (For original article, see page 71.)

DISCUSSION

DR. PHILlPP SCIIONWALD, SEATTLE, WASH.-This paper on cedar hay fever brings to my mind a problem that I have run up against and have not been able to solve; the problem of cedar asthma. Years ago I treated three cases of cedar

88 TIIE JOURNAL OF ALI>EK(iY

asthma. One patient 1vas a bookkeeper in a s:cwmill, ;Lllotller it 111:t1111facturer of

coffins which are made from cedar boards, and one WV:~S a worker in another saw. mill. They all knew the cause of their trouble. \I’lrclwve~ my w’cre nround whcrc

cedar good was handled or worked, they ~ouhl get asthma. Iiring absent from t111b factory or cluitting their \\-ork gave tlltnl ~~~‘onlpt :it~d Iwrnhmcwt relief.

I tried to approach the lnoblcm in the usu:ll \v:iy. s~mc of those three showtl

any food sensit~izntion or seusitization to airy 1~11~~11. I twtml them vvit,h rrtrnct3 made from cellar wood and from tlus sljecitic cts11:1r L\INNI that was used in e\-cry cast. I could not get, either by tllc scratcl~ mrthtbcl or tty tlw intr:rdermnl method, :t reaction to these extracts. However, I startell trc:ltment T\ ith cedar mood extract, and in one case, that of the hookkccpcr, kt*pt it “11 for ahout a year. ILC \\:I< very cooperative. I did not get any result at, all. 1 Le tlually had to quit work.

Thaw seem to be a gre:tt number of these case3, bec:iuse since tlmt time I h:l\e seen at, least a dozeu. I have sent them ax:t,y telling them I could do nothing for them. To recommend to these pcol)lc that f i~tay quit their xork or give u11 their business is a specific treatment.

I wonder \vhrther anybody in this nssemt~lg- knclws ;L little more :\l)f,ut cedar asthma.

DR. ROBERT F. E. STIER, SPORANE, \Vas~.-(‘ed:~ good :~sthnn~, particularly in this part of the country, is a rather interesting one. WC have made, just as I)r. Achonwald has done, an extract by using glycerin-salt solution. We have two cases in which we hare seeu dcfinitr relief; one an old man about seventy who had difficulty every time he worked with cedar sl~inglcs. IIe is able to work with cedar now without any difficulty. Another man is uot completely relieved bccausc he can still tell v&en there is cedar in the mill, but his attacks are not quite so swew as they xere formerly. At that time 11~3 ivould be incnp:rcit,:cted fnr a da: or so or cvcu for a week or two. Yaw it ,just t:iktzs him out of 11is \vork for th:ri day.

At the University of Idaho au :~tteml~t W:IS nu~tle to determine \\-11y cctlar lasts longer than some other types of wood. A certain essential oil iu the cedar stems responsible. It was suggested by l)r. Hubert of the University of Idallo, WIV, directed this work, that perhaps the asthma XXIS glue to till* csseutial oil of ccd:n wood. .Tust how we arc going to desensitize otlr l~atient~ I o tlr:l t ~c~l:rr \vood oil is id prol~km xvhich is as pet unsolrcd.

SOCIETY PROCEEDINGS 89

DR. J. H. BLACK, DALLAS, TEX-In answer to Dr. Cutter we have not used the ophthalmic test. In the statement with regard to those giving negative reactions, that was only incidental and was not considered in the other figures for results.

In attempting to determine the relationship of these two pollens we have not done the absorption test in the passively sensitized skins. I think that would be an interesting thing to do. The interesting thing to my mind is that some men are contending they can treat all their grass sensitive patients with timothy while timothy may not exist in their vicinity, while other men will be specific about their grass treatment. This report of mine will probably add more confusion to the subject than less.

(Proceedhp to be COlktiilUed.)