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Psychosomatic Medicine 13:71-82 (1951)
© 1951 American Psychosomatic Society

Life Situations, Emotions, And Nasal Disease

Evidence on Summative Effects Exhibited in Patients with "Hay Fever"

THOMAS H. HOLMES M.D.1, THEODORE TREUTING M.D.2, and HAROLD G. WOLFF M.D.3

1 New York Hospital and the Departments of Medicine and Psychiatry, Cornell University Medical College; Department of Psychiatry, University of Washington School of Medicine, Seattle, Washington
2 New York Hospital and the Departments of Medicine and Psychiatry, Cornell University Medical College; Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
3 New York Hospital and the Departments of Medicine and Psychiatry, Cornell University Medical College

Exposure of both "non-sensitive" and "sensitive" individuals to mixed ragweed pollen provoked a response in the nose of mucosal hyperfunction characterized by hyperemia, hypersecretion, and swelling.

The onset and intensity of hay fever symptoms and the extent of the mucous membrane reaction was directly related to the magnitude of the nasal hyperfunction existing at the time of exposure to pollen.

The intensely hyperfunctioning nasal mucous membranes, in contrast to those exhibiting average or mild hyperfunction; reacted promptly to assault by pollen with prompt, intense, and prolonged symptoms and pathologic tissue change characterized by pitting edema and opalescent pallor.

A life situation engendering conflict and anxiety and a response of nasal hyperfunction 1) enhances the intensity of the symptoms of rhinitis, and the magnitude of the mucous membrane response already present in "sensitive" subjects; or 2) enhances the response of the nasal tissues to an additional assault by pollen.

Parasympathetic neural impulses to the nose appear to be responsible for the production of the nasal hyperfunction which accompanies the individual's reaction to a situation of conflict.

The character of the hay fever syndrome appears to depend not only on the intensity of the nasal hyperfunction produced by the exposure of "sensitive" individuals to pollen, but on the magnitude and duration of the hyperemia, hypersecretion, and swelling in the nasal chambers provoked by other threats and assaults to bodily integrity. Of major importance among these etiologic factors is a life setting engendering conflict and anxiety.

The concept of the summative effects of nasal hyperfunction engendered concomitantly by two or more threats or assaults to bodily integrity appears to afford a basis for a broader understanding of the natural history of the hay fever syndrome as well as other common acute and chronic disorders of the nasal spaces.

Submitted on June 5, 1950






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Copyright © 1951 by the American Psychosomatic Society