Marked differences in the structure and physiology of the mucous membranes as compared with the skin would lead one to expect differences in their reaction to irritants. This is borne out by the observations of Duncan' and of Cooper,2 who showed that poison ivy leaf (Rhus toxicodendron) may be chewed with impunity by susceptible persons, but contact of the leaf or saliva with the skin about the month results in a severe reaction. The nasal mucosa is the primary shock tissue in cases of allergic rhinitis. Nasal tests, therefore, should be more specific and give more reliable information than skin tests in such cases.The advantages of the skin tests are principally the relative ease of application, the large number of tests that can be run at one time, and the relative freedom from severe reactions. The failure of the skin to react in many cases of allergic rhinitis, and its tendency to react to great numbers of allergens that the nasal mucosa is not sensitive to, reduces the value of the test as a diagnostic procedure in this condition. Rackemann and Simon 3 found 8 per cent of positive skin reactions in persons showing no symptoms of hypersensitiveness. It is obvious that any of the various methods of parenteral administration of antigenic substance, which results in absorption into the blood stream, may cause sensitization of the skin.The limited number of tests that can be performed, and the severe symptoms often resulting from the methods of testing m vogue, has prevented general use of mucosal tests in the nose.
My purpose in this paper is to compare the results secured by intradermal tests with those secured by intramucosal tests.
MATERIAL AND METHOD OF STUDYSixty-five cases in which the condition was diagnosed as allergic rhinitis were studied. The patients were not selected. In half of the cases there were complications, such as asthma, headache, suppuration of the nasal sinuses or deflected septums. The cutaneous tests were made by Miss Zelma Alvis. Every effort was
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