ETIOLOGY
Among the diseases encountered by the rhinologist, one of the least amenable to treatment is hyperplastic ethmoiditis with polypoid change. The etiology of this condition is still a moot question. Agreement seems general that irritation, either mechanical or chemical, plays an important rôle. Whether this is the predominant one is still sub judice. The weight of evidence would seem to relegate it to a place of secondary importance, namely, that of an excitant. Irritation does not seem to be effective unless there be an individual predisposition the nature of which is yet undetermined; perhaps its rôle is analogous to the one it plays in the production of cancer. This predisposition is of varying intensity in different persons, as we meet cases of marked polypoid degeneration in patients without recognizable pathologic change in secretion, while many with frankly purulent conditions exhibit no tendency to form polypi. If irritation is the