REVIEW of REVIEWS

Value of Nose for Diagnosis

Medical Authority Claims Many Diseases Can Be Detected by Sense of Smell.

DR. CURRAN POPE April 1 1929
REVIEW of REVIEWS

Value of Nose for Diagnosis

Medical Authority Claims Many Diseases Can Be Detected by Sense of Smell.

DR. CURRAN POPE April 1 1929

Value of Nose for Diagnosis

Medical Authority Claims Many Diseases Can Be Detected by Sense of Smell.

DR. CURRAN POPE

IF WE are to believe Dr. Curran Pope, writing in American Medicine, the nasal organs of the doctor of the future will be one of his most cherished possessions. He tells us that there was a time when the sense of smell was relied upon widely for diagnosis but that the modern doctor has lost the ability to detect a disease by its odor. He continues:

“The medical profession at the present time pays little attention to the matter and does not attempt to use the olfactory organs as it should. In this day of laboratory diagnosis a good many of the older bedside helps have been sidetracked, and among them the use of smelling. Dr. William Mayo has called attention recently to the value of the sense of smell to the surgeon. The writer believes that the smell of pus is rather characteristic, and in fact a number of the older diagnosticians did not refuse to use their nose as a means of aiding them in the diagnosis of a disease. Dr. Osier frequently stressed the importance of the sense of smell in deep infections and abscesses, especially of the lung. The writer has not had much experience in the diagnosis or investigation of smallpox, but believes that the average physician could, with a little practice, soon learn to recognize the odor of this disease. It is extremely difficult to describe a color to one who has never seen color similar to the one described, or who is blind. It is also very difficult to describe an odor save by comparison with some of the well-known or easily recognized odors of everyday life.”

The nose also knows pellagra, typhoid fever, diphtheria, and measles, we are assured:

“The writer has had quite a good deal of experience in the treatment of pellagra. He and his associates feel that they can make a diagnosis almost from the smell alone. The odor, as nearly as can be described, is that of sour or musty bread. Speaking in general terms, the presence of perspiration seems to aid in the detection of any abnormal or normal odor. Kuno has called attention to normal and abnormal perspiring. He divides people into three categories: 1. Those who have little ability to perspire, so that they barely sweat under a very high atmospheric temperature. 2. Those who sweat in accordance with the necessities of the regulation of body temperature. 3. Those who are always liable to sweat. In the latter, the sweat secretion is purposeless from the point of view of heat regulation, or it goes much beyond the necessary amount. Those in the second group are normal. The third group who overperspire usually show signs of some abnormal condition. Normal people pass into this state When they are suffering from some illness. Kuno remarks that this sign seems to have a wide application for diagnostic purposes.

“Our observations have been that odor for the purpose of diagnostic smelling is usually more difficult in those who do not perspire unless they are the subject of a moderate or high-temperature variation. For the testing of odor the second class is of course the best. The third class of excessive sweaters, as a rule, emanate odors mere pronouncedly than any other class. We all recognize the peculiar odor of the person suffering from sepsis. This is present both in the perspiration and in the breath. The writer, however, refers only to the odor that is given off by the body.

“Both of my associates and myself are of the opinion that typhoid-fever odor can be easily detected by one whose olfactories are trained in this direction. One of my associates, Dr. Keefe, states that he can detect the odor of diphtheria and measles. There is very little difficulty in detecting the ammoniacal odor associated with a case of chronic cystitis. One might say that only a very few of the possibilities of olfaction have been touched upon in this paper.

“There can be no question that all peoples and races possess racial and personal odor characteristics. This is amply borne out by the fact that a bloodhound can trace any individual by his peculiar odor. Some races have this odor very much more marked than others, probably because the olfactories of another race are more sensitive to that peculiar kind of smell. This, I think, is more pronouncedly the case with the negro.

“In so far as the Anglo-Saxon is concerned, I believe that his olfactories are more easily attuned to the detection of this odor than they are to the odors of other races. I have further observed that the mulatto has a different and even a lessened odor than the pure-blood African. Furthermore, an additional dilution, such as a quadroon, lessens the odor and changes it somewhat. Perspiration under these conditions brings out the odor in marked degree. This is true even in those of the negro race who are careful and cleanly in their habits of person and dress. They are not to blame for what is a racial characteristic any more than the Anglo-Saxon is to be blamed for his racial odor which the bloodhound can follow in either instance.

“In conclusion, it might be advised that the cultivation of the power to ‘smell out disease,’ should constantly be kept in mind as an aid among many others in the diagnosis of the different diseases to which human flesh is heir.”